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Can trained volunteers improve the mealtime care of older hospital patients?: an implementation study in one English hospital

Can trained volunteers improve the mealtime care of older hospital patients?: an implementation study in one English hospital
Can trained volunteers improve the mealtime care of older hospital patients?: an implementation study in one English hospital
Objective: multi-national studies report under-nutrition among 39% older inpatients; importantly, malnutrition risk may further increase while in hospital. Contributory factors include insufficient mealtime assistance from time-pressured hospital staff. A pilot study showed trained volunteers could safely improve mealtime care. This study evaluates the wider implementation of a mealtime assistance programme.

Design: mixed methods prospective quasi-experimental study

Setting: nine wards across Medicine for Older People (MOP), Acute Medical Unit, Orthopaedics and Adult Medicine departments in one English hospital.

Participants: patients, volunteers, ward staff.

Intervention: volunteers trained to help patients aged ≥ 70 years at weekday lunchtime and evening meals

Main outcome measures: the number of volunteers recruited, trained and their activity was recorded. Barriers and enablers to the intervention were explored through interviews and focus groups with patients, ward staff and volunteers. The total cost of the programme was evaluated.

Results: 65 volunteers (52 female) helped at 846 meals (median 8 / volunteer, range 2-109). The mix of ages (17-77 years) and employment status enabled lunch and evening mealtimes to be covered. Feeding patients was the most common activity volunteers performed, comprising 56% of volunteer interactions on MOP and 34-35% in other departments. Patients and nurses universally valued the volunteers, who were skilled at encouraging reluctant eaters. Training was seen as essential by volunteers, patients and staff. The volunteers released potential costs of clinical time equivalent to a saving of £27.04 / patient / day of health care assistant time or £45.04 of newly qualified nurse time above their training costs during the study.

Conclusions: patients in all departments had a high level of need for mealtime assistance. Trained volunteers were highly valued by patients and staff. The programme was cost-saving releasing valuable nursing time.
Trial registration - clinical trials.gov (ID NCT02229019)
volunteer, older, mealtime assistance, hospital, implementation
2044-6055
1-10
Howson, Fiona, Frances Anne
7058d707-80f8-4cf7-b270-497b18275ca0
Robinson, Sian
ba591c98-4380-456a-be8a-c452f992b69b
Lin, Sharon X.
1f505362-6947-4ca4-88b1-dd9a0ed2e11e
Orlando, Rosa
cc20c869-ca7f-4518-ad2d-0fa56caa3c86
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Howson, Fiona, Frances Anne
7058d707-80f8-4cf7-b270-497b18275ca0
Robinson, Sian
ba591c98-4380-456a-be8a-c452f992b69b
Lin, Sharon X.
1f505362-6947-4ca4-88b1-dd9a0ed2e11e
Orlando, Rosa
cc20c869-ca7f-4518-ad2d-0fa56caa3c86
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253

Howson, Fiona, Frances Anne, Robinson, Sian, Lin, Sharon X., Orlando, Rosa, Cooper, Cyrus, Aihie Sayer, Avan and Roberts, Helen (2018) Can trained volunteers improve the mealtime care of older hospital patients?: an implementation study in one English hospital. BMJ Open, 8 (8), 1-10. (doi:10.1136/bmjopen-2018-022285).

Record type: Article

Abstract

Objective: multi-national studies report under-nutrition among 39% older inpatients; importantly, malnutrition risk may further increase while in hospital. Contributory factors include insufficient mealtime assistance from time-pressured hospital staff. A pilot study showed trained volunteers could safely improve mealtime care. This study evaluates the wider implementation of a mealtime assistance programme.

Design: mixed methods prospective quasi-experimental study

Setting: nine wards across Medicine for Older People (MOP), Acute Medical Unit, Orthopaedics and Adult Medicine departments in one English hospital.

Participants: patients, volunteers, ward staff.

Intervention: volunteers trained to help patients aged ≥ 70 years at weekday lunchtime and evening meals

Main outcome measures: the number of volunteers recruited, trained and their activity was recorded. Barriers and enablers to the intervention were explored through interviews and focus groups with patients, ward staff and volunteers. The total cost of the programme was evaluated.

Results: 65 volunteers (52 female) helped at 846 meals (median 8 / volunteer, range 2-109). The mix of ages (17-77 years) and employment status enabled lunch and evening mealtimes to be covered. Feeding patients was the most common activity volunteers performed, comprising 56% of volunteer interactions on MOP and 34-35% in other departments. Patients and nurses universally valued the volunteers, who were skilled at encouraging reluctant eaters. Training was seen as essential by volunteers, patients and staff. The volunteers released potential costs of clinical time equivalent to a saving of £27.04 / patient / day of health care assistant time or £45.04 of newly qualified nurse time above their training costs during the study.

Conclusions: patients in all departments had a high level of need for mealtime assistance. Trained volunteers were highly valued by patients and staff. The programme was cost-saving releasing valuable nursing time.
Trial registration - clinical trials.gov (ID NCT02229019)

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More information

Accepted/In Press date: 28 June 2018
e-pub ahead of print date: 5 August 2018
Keywords: volunteer, older, mealtime assistance, hospital, implementation

Identifiers

Local EPrints ID: 423022
URI: https://eprints.soton.ac.uk/id/eprint/423022
ISSN: 2044-6055
PURE UUID: 9df6aa59-bbab-4ea2-b466-c8114615dd50
ORCID for Sian Robinson: ORCID iD orcid.org/0000-0003-1766-7269
ORCID for Rosa Orlando: ORCID iD orcid.org/0000-0002-7097-5431
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Helen Roberts: ORCID iD orcid.org/0000-0002-5291-1880

Catalogue record

Date deposited: 10 Aug 2018 16:30
Last modified: 10 Dec 2019 01:58

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