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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
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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 (pam.sykes@ths.tas.gov.au).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com).

The authors declare no conflict of interest.

Accepted for publication: June 15, 2018

Published ahead of print: September 6, 2018

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