Improving food services for elderly, long‐stay patients in Australian hospitals: Adding food fortification, assistance with packaging and feeding assistance

Abstract

Aim:To highlight barriers and feasible opportunities to enhance nutrition support of long-stay patients in Australian hospitals. Methods:A total of 218 dietitians, nurse unit managers and food service managers from medical and rehabilitation wards of 184 hospitals completed a web based survey about current practices, perceived barriers and priority opportunities to enhance nutrition support.Results: Cook-fresh was the most commonly reported food-service system (50%). Eighty-eight percent still used paper menus and one-or two-week cycles were the most common menu cycle lengths. Lack of choice due to special diet, boredom arising from the length of stay, a lack of feeding assistance, limited variety and inadequate flexibility of food service were the key barriers identified. Food fortification, assistance with packaging, additional feeding assistance by nurses, non nursing feeding assistance and further nutrition assessment were key priorities for improvement.

Improving opportunities for food service and dietetics practice in hospitals and residential aged care facilities

“…There is not one intervention that will improve dietary intakes for all concerned because so many factors have an impact on the volume of food consumed. Additional interventions include: adequate flexibility of menu choices, serving size options, food fortification, protected mealtimes, additional mealtime assistance, nourishing snacks and an improved variety of menu options as close as possible to the point of service 18,24,29,32,46 . A number of these interventions will come with a significant cost, and advocacy will be essential to elevate the profile of food services in the hospital environment.…”

“…The adequate provision of food and nutrition services to best suit long‐stay patients and the elderly is an enormous collage that is interwoven with numerous facets, including: professional expectations, patient expectations, budgets and communication. A recent Australian survey of nurse unit managers, food service managers and dietitians explored barriers to dietary intakes and opportunities for improvements 46 . Dietitians and food service managers identified several common barriers (limited nutritional assessment and communication between staff); as did dietitians and nurse unit managers (lack of flexibility of food service and taste of food).…”

“…Dietitians are in a strategic liaison position that may focus on sound communication and advocacy strategies to assist others in realising the complexities involved in improving dietary intakes. There is not one single solution to address patients' poor dietary intakes, but rather a multidisciplinary approach with numerous available strategies 46 …”

“…A recent Australian survey of nurse unit managers, food service managers and dietitians explored barriers to dietary intakes and opportunities for improvements. 46 Dietitians and food service managers identified several common barriers (limited nutritional assessment and communication between staff); as did dietitians and nurse unit managers (lack of flexibility of food service and taste of food). Dietitians and food service managers also identified the same intervention opportunities (additional feeding assistance by nurses, non-nursing feeding assistance available at meals and additional assistance to set up for meals); as did dietitians and nurse unit managers (more nourishing between meal snacks and an improved variety of menu options).…”

“…There is not one single solution to address patients' poor dietary intakes, but rather a multidisciplinary approach with numerous available strategies. 46…”