The impact of trained volunteer mealtime assistants on dietary intake and satisfaction with mealtime care in adult hospital inpatients: A systematic review

Abstract

BackgroundMalnutrition is common in hospital inpatients and is associated with increased morbidity and mortality. Insufficient assistance at mealtimes can contribute to this and therefore trained volunteer mealtime assistants may be of benefit. ObjectivesTo identify and review the current evidence for the impact of trained volunteer mealtime assistants on dietary intake and satisfaction with mealtime care in adult hospital inpatients. MethodsA systematic search of Medline, Embase and CINAHL was conducted to identify relevant articles. Articles of any methodology were considered. Quality assessment and data extraction were carried out by two reviewers independently. ParticipantsParticipants were inpatients in a hospital setting, including rehabilitation units. Participants in long term care facilities were excluded. InterventionArticles that examined the effect of trained volunteer mealtime assistants on nutritional outcomes or satisfaction with mealtime care were included. Results 5576 articles were identified, of which 14 were included in the review. Nine were small research studies and five were quality improvement initiatives. The quality of eight studies was moderate, with one study being of lower quality. Eight articles reported dietary intake and seven demonstrated an improvement, with protein intakes at volunteer mealtimes increasing by 4.3g-10.1g and energy intakes by 44-105kcal. Ten articles reported positive staff, patient and volunteer feedback. No adverse events were reported. ConclusionThere is evidence from small studies and improvement projects that trained volunteer mealtime assistants are safe and improve satisfaction with mealtime care in hospital inpatients, although evidence for an effect on dietary intake was less consistent. Larger studies with robust methodology are required to confirm this.

Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach

“…Evidence for an effect on dietary intake was inconclusive in the review by Howson et al (2016), while the meta-analyses of Tassone et al (2015) favoured the provision of mealtime assistance. Original research has also found that volunteer involvement at mealtimes enables staff to complete other tasks (Roberts et al, 2014) and contributes to cost savings (Buys, Flood, Real, Chang, & Locher, 2013).…”

“…Reported benefits include improved nutritional intake (Edwards, Carrier, & Hopkinson, 2017;Green, Martin, Roberts, & Sayer, 2011) and satisfaction (Green et al, 2011;Howson, Sayer, & Roberts, 2016).…”

Interventions to prevent and treat malnutrition in older adults to be carried out by nurses: A systematic review

“…We identified four types of interventions, which had also been evaluated in previous systematic reviews and meta‐analyses (Allen et al, ; Avenell et al, ; Bandayrell & Wong, ; Milne et al, ; Morilla‐Herrera et al, ; Munk et al, ). Additionally, in one review trained volunteer mealtime assistants (Howson et al, ) and in one meta‐analysis multidisciplinary support (Rasmussen et al, ) had been investigated. Given the inclusion criteria, these interventions were not assessed in our review, but could possibly add to nursing care to prevent and treat malnutrition in older adults.…”

“…In a number of systematic reviews and meta‐analyses, one or more evidence‐based interventions for the prevention and treatment of malnutrition to support oral nutritional care are described (Allen, Methven, & Gosney, ; Avenell, Smith, Curtain, Mak, & Myint, ; Bandayrell & Wong, ; Howson, Sayer, & Roberts, ; Milne, Potter, Vivanti, & Avenell, ; Morilla‐Herrera et al, ; Munk et al, ; Rasmussen et al, ). These systematic reviews and meta‐analyses have illustrated contrasting results with both significant and nonsignificant effects on outcomes related to malnutrition.…”

Meeting the nutritional needs of older patients in the hospital setting

“…However, poor nutrition among this population in hospital setting appears to be a global problem and it is often associated with increased mortality, morbidity and longer lengths of hospital stay (Roberts, 2017). In the UK, the prevalence of malnutrition in patients admitted to the medical ward was estimated to be about 34% and a comparable prevalence level of about 38.7% was reported among hospitalised patients aged over 65 years in a multinational study (Howson et al, 2017). In another study in rural Wales, Rasheed and Woods (2013) found 44% of patients older than 60 years admitted to hospital were malnourished at first assessment.…”