Nutrition in Hospitals: Mealtimes Matter

Abstract

ageWise is a nurseresidency in geropalliative care for nurses working in NICHE member hospitals with Magnet designation. For more information, see http://champion nursing.org/blog/nurse-residency-geropalliative-care. As part of my (CR) Florence Nightingale scholarship, I traveled to New York University from Nottingham, England. Working with Drs. Elizabeth Capezuti and Marie Boltz, and visiting hospitals where the NICHE (Nurses Improving Care of Healthsystem Elders) program has been successfully implemented helped to develop my understanding of best practice in geriatric nursing. From pressure ulcer prevention to the care of the older person with delirium, the issues we face as acute care geriatric nurses are essentially the same on both sides of the Atlantic, although it was soon obvious to me that there is much we can learn from the different practices that have been developed in our respective hospitals. One issue facing all of us is the need to promote good nutrition among the older inpatient population. The prevalence of malnutrition in older hospitalized patients has been estimated to be as high as 39%, with another 47% of patients at risk for malnutrition. Malnutrition in older inpatients is associated with important adverse outcomes, such as increased morbidity and mortality and decreased quality of life. Although a considerable number may be malnourished when admitted, the lack of adequate food intake during hospitalization is considered a major contributing factor. The latter is influenced by the person’s lack of appetite due to their underlying medical conditions, treatments (e.g., medications that reduce taste or result in xerostomia) or physical functioning (chewing and swallowing problems). The physical (e.g., eating in bed) or social (eating alone) environment may also not be conducive for meals.