Finding the time – Audit of mealtime processes and support on a busy acute ward

Abstract

Study aims were to validate agreement between the weighed intake method and the EWFRC record and to assess the effectiveness of the tool for identification of nutritional risk. Data was collected from 35 patients (male n¼16, female n¼19) over a consecutive three day period on two acute medical wards. 393 meals were weighed pre and post-delivery to patients over three meal occasions (breakfast, lunch and evening meal) and compared with intake recorded on the EWFRC. Comparison of means was conducted using ANOVA. Agreement between the weighed intake and EWFRC methods was tested using Bland-Altman plots (CI¼95%) with linear regression analysis used to determine significance (p¼0.05). Overall limits of agreement between the EWFRC and the weighed intake method were wide (À75.1 e +100%), therefore, do not accurately represent oral intake. Non-contemporaneous completion of the EWFRC based on patient recall may have influenced this result. Narrow limits of agreement were demonstrated (À17-19.5, p¼0.944) for 49 meals, which suggests that the EWFRC has potential to accurately represent oral intake when completed contemporaneously after direct observation of the meal. 18 patients remained on the ward for the duration of the three day period and their data was analysed to validate the accuracy of the EWFRC for prediction of nutritional risk. Comparison of nutritional risk between the two methods did not reach statistical significance. The EWFRC identified patients at low (n¼9 vs n¼10 from weighed intake), moderate (n¼1 vs n¼2 from weighed intake) and high nutritional risk (n¼5 vs n¼6 from weighed intake). The EWFRC is, therefore, a valid tool for prediction of nutritional risk over a three day period and may accurately record oral intake if completed contemporaneously and when meals have been observed. References [1] Palmer M, Miller K, Noble S. The accuracy of food intake charts completed by nursing staff as part of usual care when no additional training in completing intake tools is provided. Clin Nutr.