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Mealtime Assistance ... From Chaos to Calm

A Collaborative Best Practice Implementation Project

Sykes, Pamela, MN, RN; Norris, Ian, DipBus, DipHospMgt; Cook, Megan, BN, RN; Woods, Aaron; Boughton, Rachel, BN, RN; Chilcott, Kylie, BN, RN; Walsh, Kenneth, PhD, RN

doi: 10.1097/NCQ.0000000000000352

Background: Providing appropriate and timely mealtime assistance to hospitalized patients should be part of a multifaceted and multidisciplinary approach to optimizing a patient's nutritional care plan.

Problem: There was anecdotal evidence at the study hospital that patients did not receive adequate and/or timely assistance at mealtimes.

Approach: A best practice implementation project, using a proven strategy of audit, feedback, and reaudit, was used to effect practice change on an acute general medical ward.

Outcomes: The combined interventions of staff engagement, redesigning the model of care to reprioritize activities at mealtimes, clarifying nutritional care roles and responsibilities, introducing a protected mealtime and a novel 2-tiered colored tray system, and implementing an awareness and education program have resulted in significant improvements in mealtime assistance.

Conclusions: Success of the project is considered to be replicable and sustainable hospitalwide and more broadly.

Joanna Briggs Institute, Adelaide, Australia (Ms Sykes and Dr Walsh); Centre for Education & Research (Mss Sykes, Cook, and Chilcott), Food Services (Messrs Norris and Woods), and General Medicine Respiratory (Ms Boughton), Royal Hobart Hospital, Tasmania, Australia; and Tasmanian Health Service and School of Health Sciences, University of Tasmania, Australia (Dr Walsh).

Correspondence: Pamela Kathleen Sykes, MN, RN, Centre for Education & Research, Royal Hobart Hospital, Commonwealth Bank Bldg, Level 2, 81 Elizabeth St, Tasmania 7000, Australia (

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The authors declare no conflict of interest.

Accepted for publication: June 15, 2018

Published ahead of print: September 6, 2018

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