Wednesday, 23 March 2016

Protected mealtimes - worth the effort?

Roger Watson, Editor-in-Chief

Protected mealtimes became very 'trendy' a few years ago due to the idea that patients, especially those who have difficulty eating, eat less and their nutrition becomes compromised when they are disturbed, for example, by consultant rounds or medicine administration. I know that one small study I was involved in showed that they were ineffective but that was carried out on the basis of audit and not a rigorously designed research study.

Two studies from Australia and published in JAN investigate protected mealtimes.The first by Young et al. (2016) titled: 'Assisted or Protected Mealtimes? Exploring the impact of hospital mealtime practices on meal intake' aimed to: 'evaluate the impact of mealtime practices (meal time preparation, assistance and interruptions) on meal intake of inpatients in acute hospital wards.' A survey design was used. Counterintuitively: 'There was no difference in meal intake between patients who were interrupted, compared with those who were not interrupted.' Various aspects of positioning and assisting were shown to be effective in helping patients to eat and the authors conclude: 'clinicians and managers should consider adopting an ‘assisted mealtimes’ focus to improve meal intake, rather than only focusing on Protected Mealtimes.'

The second study by Porter et al. (2016) titled: 'Implementation of protected mealtimes in the subacute setting: stepped wedge cluster trial protocol' aims 'to determine if protected mealtimes implementation closes the energy deficit of 1900 kJ between estimated requirements and actual energy intake of hospitalized adults in the subacute setting.' Given the outcome of the previous study, it will be interesting to see what the outcome of this study is. It is good that the evidence-base is building in this important area of patient care and that JAN is contributing to it.


You can listen to this as a podcast.


References

PORTER J., HAINES T. & TRUBY H. (2016) Implementation of protected mealtimes in the subacute setting: stepped wedge cluster trial protocol. Journal of 1 Advanced Nursing doi: 10.1111/jan.12930


YOUNG A. , ALLIA A. , JOLLIFFE L . , DE JERSEY S . , MUDGE A. , MCRAE P. & BANKS M. (2016) Assisted or Protected Mealtimes? Exploring the impact of hospital mealtime practices on meal intake. Journal of Advanced Nursing doi: 10.1111/jan.12940

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