Oral Presentations in Order of Conference Program

Abstract

Overview: Malnutrition remains a key issue in the acute care setting, the negative patient and fiscal outcomes of which are supported by a strong evidence-base. One risk factor for the development of malnutrition is decreased food intake. In the acute setting food intake can be influenced by access to food, self-feeding difficulty, meal-time interruptions and the eating environment. This joint nursing-dietetic prospective study was undertaken in the neuroscience unit (30 beds) at an acute tertiary hospital in Brisbane, Australia. The aim of this study was to reduce the risk of hospital acquired malnutrition by identifying and addressing ward-based barriers to adequate patient food intake. Methodology included identification of ward mealtime practices, staff focus groups and patient's risk of malnutrition via Malnutrition Screening Tool. Data from observation (n = 406) of physical positioning of patient and their food tray, adequacy of assistance provided, effect of mealtime interruptions on food intake and plate wastage assessment informed a five-month trial and comprehensive marketing and education campaign to all clinical and non-clinical staff. Post-trial data highlighted a significant change in ward practices with improvements in all baseline variables. Of particular relevance was the 24.3% and 21.6% increase in food intake observed in the patient groups identified as at risk of malnutrition or as requiring mealtime assistance respectively. This study shows that a reorganisation in culture whereby mealtimes are protected from non-essential interruptions and nursing staff, volunteers and families are supported to assist patients with their meals has a profound impact on food intake of patients in the acute care setting.