UHD and Bournemouth Uni explore nutritional care for patients

A collaborative project between University Hospitals Dorset (UHD) and Bournemouth University (BU) has explored how to optimise nutritional care for patients while they are in hospital.

Good nutritional care is fundamental to patient recovery and in reducing complications associated with malnutrition (undernutrition). Approximately 34% of individuals aged 65 and over who are admitted to hospital are at risk or are already suffering from malnutrition.

However, providing optimum hydration and appropriate mealtime support for patients who need it is often met with many challenges for staff with competing clinical tasks in a pressurised acute clinical environment.

The research project was part of a PhD studentship, jointly funded by UHD and BU, to explore how organisational culture may influence optimal food and nutritional care.

Gladys Yinusa, Post-Doctoral Research Fellow in BU’s Ageing and Dementia Research Centre (ADRC), who led the study, said: “Good food and nutritional care are fundamental to patient-centred care. Hospital staff and the organisational systems in which they work have a vital role to play in ensuring patients’ nutritional needs are met.”

The research project brought together a multidisciplinary action research team comprising both clinical and non-clinical staff, including mealtime volunteers and hospital governor representatives. The experiences of recently discharged patients and their relatives were also collected in the form of stories.

“The patients' and relatives' views offered remarkable insights, highlighting areas of practice change,” said Gladys.

“These insights contributed to the team’s collective decision to prioritise areas for improvement in ward practice during mealtimes. In particular, critical findings from this study revealed that organisational culture does matter and plays a significant role in providing food and nutritional care in hospitals.”

The project led to prioritising changes in ward practices during mealtimes. These focused on embedding mealtime companions as part of the ward team and implementing a colour-coded system to identify patients who need assistance with feeding. The research showed that mealtime companions played a significant role in supporting patients during mealtimes, but the volunteer service was not being used to its full benefit.

Gráinne Ford, UHD therapy lead for dietetics, was also part of the study team.

She said: “Good nutritional care is a vital part of delivering a quality service to our patients and to recovery and wellbeing at all stages. I feel it’s important to explore this through research in order to raise awareness and understanding of malnutrition in the acute setting and to advance the nutritional care of patients and those at risk from malnutrition.

“Exploring organisational culture and its effects on nutritional care of our patients is so important to help us achieve improvements in quality of care, patient experience and patient safety. Collaborative working with our partners at BU has brought research to the frontline to explore one of our most difficult problems.”

The PhD project was supervised by Gráinne Ford (University Hospital Dorset) and Dr Janet Scammell, Professor Jane Murphy, and Dr Sue Baron (Bournemouth University).