Adherence to Protected Mealtime Guidelines: A Comparison between an Acute and Community Hospital

Abstract

Background: Between 25-34% of patients admitted to hospital are at risk of malnutrition, BAPEN [1]. Protected mealtimes ensure all non-essential interruptions are limited so patients are eating in a clean, quiet and safe environment, HIS [2]. The aim of this evaluation was to determine whether 2 Hospitals within a Scottish Health Board adhered to the implemented protected mealtimes guidelines. Methods: Thirty Mealtimes (843 patients), were observed by one observer over twelve days (weekdays only) using Healthcare Improvement Scotland Observation Tool for Protected Mealtimes (HIS, 2011). Protected mealtimes were observed in four wards in an acute hospital and one ward in a community hospital at breakfast, lunch and dinner and then repeated. Ethical approval was granted by The Life Sciences Human Subjects Research Ethics Committee of Glasgow Caledonian University.  Discussion: The findings from this study indicate that the delivery of nutritional care was seen as a low priority; all appropriate nutritional care was not always provided. A recent study by Huxtable and Palmer [3] found that a protected mealtime programme increased nursing staff availability at mealtimes, which allowed the delivery of appropriate assistance, but also increased mealtime interruptions. Education and training of ward staff in the importance of the delivery of nutritional care, and the consequences of poor nutritional care is essential to ensure optimum nutritional care is received by each patient and protected mealtime guidelines are adhered to correctly. Conclusion: This studied showed that protected mealtime guidelines were frequently not adhered to, predominantly more so in the acute setting, indicating patients did not receive optimum nutritional care.