Aspects of protected mealtimes are associated with improved mealtime energy and protein intakes in hospitalized adult patients on medical and surgical wards over 2 years.

Abstract

Protected mealtimes programs aim to improve inpatient intakes. Yet its efficacy has not yet been established. We aimed to determine which patient-related factors and aspects of protected mealtimes, for example, mealtime assistance and meal within reach, were associated with energy and protein intakes of adult inpatients on medical and surgical wards. Patient characteristics and dietary intake data were collected at main meals over 2 years. Proportions of individual foods and drinks consumed were visually estimated and converted to nutrients using averaged ready reckoner data. Mealtime factors associated with energy and protein intakes were determined using multivariate linear hierarchical regression analyses. Over 2 years, mealtime nutrient intakes of 798 inpatients were calculated ((63 ± 19) years, 52% male). Average intakes at main meals were 1419 ± 614 kJ and 15 ± 7 g protein. Inpatient intakes were significantly associated with gender, age, season, stopping or refusing a meal, time until discharge and eating at dinner (B = -829-222 kJ, B = -8.8 to 2.2 g protein, P = 0.000-0.032). Protected mealtimes program implementation was not associated with inpatient intake (P=0.094-0.157). However, aspects of protected mealtimes were associated with intake. This included requiring and documenting the need for mealtime assistance, introduction of mealtime volunteers, time to eat and appropriate positioning during mealtimes (B = 177-296 kJ, B = 0.07-3.9 g protein, P=0.000-0.014, R(2) = 0.148-0.154). In those specifically requiring mealtime assistance, inpatient protein intake was associated with mealtime volunteers and appropriate positioning (B = 4.1-4.4 g protein, P = 0.013-0.026, R(2) = 0.197). Aspects of protected mealtimes were associated with improved intake. Identifying these achievable aspects during planning and ensuring successful implementation of protected mealtimes may be critical for optimizing acute inpatient intake.