Reclaiming time for nursing practice in nutritional care: outcomes of implementing Protected Mealtimes in a residential aged care setting

Ullrich, Sandra; McCutcheon, Helen; Parker, Barbara A.

doi:10.1111/j.1365-2702.2010.03598.x

Cited by 39 publications

(55 citation statements)

References 30 publications

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“…Our study supports the importance of mealtimes in neurological settings and shows that there was room for setting a new and better scene. This is in line with earlier studies that emphasized the necessity of changing mealtime practices because mealtime care was considered to have low priority and status compared with other tasks by caregivers (Martinsen & Norlyk, 2012; Ullrich et al, 2011). Similarly, our study identifies that in traditional settings, mealtime care before the intervention was not considered naturally integrated into care and rehabilitation, even though mealtime care has been recognized as an important element in the treatment of patients with neurological diseases (Jefferies, Johnson, & Ravens, 2011; Martinsen, 2005).…”

Section: Comprehensive Understanding and Discussionsupporting

confidence: 90%

“…This contrasts with the findings by Huxtable and Palmer (2013) that suggested that interruptions by the caregivers were increased by providing Protected Mealtimes. However, our study showed, in line with Ullrich et al (2011), that mealtime interventions inspired by Protected Mealtimes are not only about decreasing interruption during mealtimes, but also about providing ownership of mealtime activity to the caregivers, resulting in an increased priority of mealtime care.…”

Section: Comprehensive Understanding and Discussionsupporting

confidence: 89%

“…Changing practices in this setting is a complex process that has proven to be challenging because the routines and attitudes that are part of a hospital’s organizational culture are often not easy to change (Copnell & Bruni, 2006). However, research suggests that the involvement of staff has a positive effect on the implementation of the interventions in practice (Dickinson & Welch, 2006; Ullrich, McCutcheon, & Parker, 2011). Because motivation can be difficult to establish, McCormack, Manley, Kitson, Titchen, & Harvey (1999) emphasized the importance of internal facilitators during practice development.…”

Section: Methodsmentioning

confidence: 99%

“…This instruction consisted of a mandatory one-hour lesson focused on mealtime and nursing care (Dickinson, Welch, & Ager, 2008; Ullrich et al, 2011). The teaching courses continued for 3 months (August– November 2016) and ended by inviting all staff members to a “Kick-off” day, during which invited speakers presented the different mealtime components, and the new mealtime policy Quiet Please was presented again.…”

Section: Methodsmentioning

confidence: 99%

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Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Beck

Martinsen

Birkelund

et al. 2017

International Journal of Qualitative Studies on Health and Well

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The British concept named Protected Mealtimes is known for stopping all non-acute activities and giving health professionals an opportunity to focus on providing patients their meals without being interrupted or disturbed. PM involves a cultural and behavioural change in the clinical setting, since health professionals are asked to adjust their daily routines. This study investigate how health professionals experience participating in a mealtime intervention inspired by the concept of Protected Mealtimes and intend to change mealtime practices. Three focus group interviews was conducted and included a total of 15 interdisciplinary staff members. After transcribing the interviews, the text material was analysed and interpreted in a three-methodological-step process inspired by the French philosopher Paul Ricoeur.In the analysis and interpretation three themes was identified. The themes were: (1) a chance towards a new and better scene; (2) a step towards a more neurologically friendly environment; and (3) a renewed view of the neurological patients. This study concludes that to the health professionals, the intervention was meaningful in several ways because it created structure during mealtimes and emphasized the importance of creating a calm environment for both patients and health professionals. The intervention was described as an eye-opening and well-regarded event in the field of neurological care that facilitated community, and reflections on nursing care and professional identity were expressed.

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Section: Comprehensive Understanding and Discussionsupporting

confidence: 90%

Section: Comprehensive Understanding and Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Beck

Martinsen

Birkelund

et al. 2017

International Journal of Qualitative Studies on Health and Well

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“…Many of the action research papers describe studies involving nurses or allied health professionals. These include the study by Ullrich et al,183 who claim that by employing a participatory worldview and action research they were able to introduce protected mealtimes for older people in a residential care setting in South Australia. Other studies describe a broader group of health-care professionals such as a study based in a centre for women's health in Boston, USA, that again did not give quite enough detail on improved health-care performance to be included in the focused review.…”

mentioning

confidence: 99%

Engagement in research: an innovative three-stage review of the benefits for health-care performance

Hanney

Boaz

Jones

et al. 2013

Health Services and Delivery Research

102

160

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BackgroundThere is a widely held assumption that research engagement improves health-care performance at various levels, but little direct empirical evidence.ObjectivesTo conduct a theoretically and empirically grounded synthesis to map and explore plausible mechanisms through which research engagement might improve health services performance. A review of the effects on patients of their health-care practitioner's or institution's participation in clinical trials was published after submission of the proposal for this review. It identified only 13 relevant papers and, overall, suggested that the evidence that research engagement improves health-care performance was less strong than some thought. We aimed to meet the need for a wider review.MethodsAn hourglass review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves health care; and (3) a wider (but less systematic) review of papers identified during the two earlier stages. Studies were included inthe focused review if the concept of ‘engagementinresearch’ was an input and some measure of ‘performance’ an output. The search strategy covered the period 1990 to March 2012. MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and other relevant databases were searched. A total of 10,239 papers were identified through the database searches, and 159 from other sources. A further relevance and quality check on 473 papers was undertaken, and identified 33 papers for inclusion in the review. A standard meta-analysis was not possible on the heterogeneous mix of papers in the focused review. Therefore an explanatory matrix was developed to help characterise the circumstances in which research engagement might improve health-care performance and the mechanisms that might be at work, identifying two main dimensions along which to categorise the studies:the degree of intentionalityandthe scope of the impact.ResultsOf the 33 papers in the focused review, 28 were positive (of which six were positive/mixed) in relation to the question of whether or not research engagement improves health-care performance. Five papers were negative (of which two were negative/mixed). Seven out of 28 positive papers reported some improvement in health outcomes. For the rest, the improved care took the form of improved processes of care. Nine positive papers were at a clinician level and 19 at an institutional level. The wider review demonstrated, for example, how collaborative and action research can encourage some progress along the pathway from research engagement towards improved health-care performance. There is also evidence that organisations in which the research function is fully integrated into the organisational structure out-perform other organisations that pay less formal heed to research and its outputs. The focused and wider reviews identified the diversity in the mechanisms through which research engagement might improve health care: there are many circumstances and mechanisms at work, more than one mechanism is often operative, and the evidence available for each one is limited.LimitationsTo address the complexities of this evidence synthesis of research we needed to spend significant time mapping the literature, and narrowed the research question to make it feasible. We excluded many potentially relevant papers (though we partially addressed this by conducting a wider additional synthesis). Studies assessing the impact made on clinician behaviour by small, locally conducted pieces of research could be difficult to interpret without full knowledge of the context.ConclusionsDrawing on the focused and wider reviews, it is suggested that when clinicians and health-care organisations engage in research there is the likelihood of a positive impact on health-care performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved health-care performance. Further explorations are required of research networks and schemes to promote the engagement of clinicians and managers in research. Detailed observational research focusing on research engagement within organisations would build up an understanding of mechanisms.Study registrationPROSPERO: CRD42012001990.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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