The implementation of trained volunteer mealtime assistants in four hospital departments

Abstract

Malnutrition is a common problem in older people admitted to hospital, and it is associated with negative healthcare outcomes and considerable healthcare costs. One factor that has been identified as contributory to this is insufficient assistance for patients at mealtimes. A systematic review identified small studies and service improvement projects where volunteers were trained as mealtime assistants and demonstrated that this is feasible and safe, and has a positive impact on satisfaction with mealtime care, although evidence of an effect on dietary intake was unconfirmed. No large-scale studies were identified by this review. This study examined the implementation of volunteer mealtime assistants in four departments of a large university hospital. Volunteers were introduced to Medicine for Older People, the Acute Medical Unit, Trauma & Orthopaedics and General Medicine. Each department was described by characterising 50 patients and measuring dietary intake and nutritional indices on each ward. Implementation was described in terms of adoption (volunteer recruitment, training and characteristics), feasibility (volunteer sessions and activity), sustainability (volunteer retention), acceptability (patients, staff and volunteer interviews and focus groups) and implementation cost. 201 participants were recruited from the four departments. Multimorbidity, polypharmacy and frailty were common, as was risk of malnutrition; dietary intake was often insufficient. 64 volunteers were recruited and adopted across the departments, where they delivered 846 sessions and recorded assisting 1721 patients. The intervention was sustainable, with 52% of volunteers continuing to be active at the end of the study. Patients and staff found the volunteer programme acceptable and volunteers enjoyed their role. The programme released £17,131-£32,359 in staff costs. This study has demonstrated that volunteer mealtime assistants can be successfully trained and implemented in four different hospital departments, and are received positively by both patients and staff. Strategies must be put in place to support volunteers and ongoing training is required to maintain volunteer numbers, but the costs of this are more than offset by staff costs released.

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ORCID for Helen Roberts: orcid.org/0000-0002-5291-1880

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