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Should we implement mealtime assistance in the hospital setting? A systematic literature review with meta‐analyses

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  • Eliza C Tassone
  • Jasmin A Tovey
  • Jessica E Paciepnik
  • Isabel M Keeton
  • Anthony Y Khoo
  • Nicholas G Van Veenendaal
  • Judi Porter

Abstract

Aims and objectives This review aimed to determine the effect of mealtime assistance provided to hospitalised patients (≥65 years) by nurses, trained staff or volunteers on nutritional and anthropometric outcomes. Background Malnutrition is a critical issue in hospitals with a reported prevalence of 20–50%. Nutritional supplementation has been associated with increased weight gain, improved function and decreased mortality; however, other system approaches including mealtime assistance may also contribute to improving nutritional intake. Design A systematic literature review. Methods Six electronic databases (CINAHL Plus, Cochrane Library, ProQuest Nursing and Allied Health Source, Scopus, PsycINFO and MEDLINE) were searched from their inception to August 2014. Inclusion criteria were hospitalised patients ≥65 years, provided mealtime assistance by nurses, volunteers or trained staff. Studies were examined for quality and risk of bias. Outcome data were combined narratively and by meta‐analyses. Results From 5458 publications, five studies met the inclusion criteria. Studies were rated neutral and positive according to the Academy of Nutrition and Dietetics Quality Checklist. Adherence to study protocols was not always reported. Meta‐analyses demonstrated significantly greater daily energy and protein intake where mealtime assistance was provided. Anthropometric outcomes generally did not differ significantly with mealtime assistance. Observation and sampling bias were noted in several studies. Conclusions There is evidence that mealtime assistance increases daily energy and protein intake in hospitalised patients (≥65 years). More robust research is needed to elucidate whether this strategy may be an effective means of addressing the high prevalence of malnutrition in hospitals. Relevance to clinical practice The evidence identified suggests that mealtime assistance provided to hospitalised older patients (≥65 years) leads to a statistically significant increase in energy and protein intake. For many patients, this increase in both energy and protein intake will be clinically significant, reducing the gap between requirements and actual intake.

Suggested Citation

  • Eliza C Tassone & Jasmin A Tovey & Jessica E Paciepnik & Isabel M Keeton & Anthony Y Khoo & Nicholas G Van Veenendaal & Judi Porter, 2015. "Should we implement mealtime assistance in the hospital setting? A systematic literature review with meta‐analyses," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(19-20), pages 2710-2721, October.
    • Handle: RePEc:wly:jocnur:v:24:y:2015:i:19-20:p:2710-2721
    DOI: 10.1111/jocn.12913
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    References listed on IDEAS

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    1. Sue M Green & Helen J Martin & Helen C Roberts & Avan Aihie Sayer, 2011. "A systematic review of the use of volunteers to improve mealtime care of adult patients or residents in institutional settings," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(13‐14), pages 1810-1823, July.
    2. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    1. Rosemary Saunders & Karla Seaman & Renée Graham & Angela Christiansen, 2019. "The effect of volunteers’ care and support on the health outcomes of older adults in acute care: A systematic scoping review," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4236-4249, December.
    2. Loris Bonetti & Stefano Terzoni & Maura Lusignani & Marina Negri & Marco Froldi & Anne Destrebecq, 2017. "Prevalence of malnutrition among older people in medical and surgical wards in hospital and quality of nutritional care: A multicenter, cross‐sectional study," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 5082-5092, December.
    3. Ella Ottrey & Claire Palermo & Catherine E. Huggins & Judi Porter, 2018. "Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(7-8), pages 1571-1579, April.

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