title: The efficacy of protected mealtimes in reducing mealtime interruptions and improving mealtime assistance in adult inpatients in an Australian hospital.
abstract: OBJECTIVE
  A Protected Mealtimes Programme (PMP) encourages staff, volunteers and visitors to assist patients and cease non-urgent clinical activity during mealtimes. Given the limited evidence available establishing the efficacy of PMP, we compared mealtime interruptions, mealtime assistance received and nutrient intakes before and after PMP implementation in adult inpatients on acute wards.
  
  
  METHODS
  Data collected on patients at main meals before and after PMP implementation included the following: diet code, level of assistance required and received and by whom, time available to consume the meal, position of the patient and tray during eating, type of interruption and by whom and proportion of foods and drinks consumed. Outcomes pre- and post-PMP implementation were compared using χ(2), independent samples t-tests and logistic regression analyses.
  
  
  RESULTS
  Over two years, 1632 inpatient mealtime observations were conducted (65 (18) years, 51% M). Similar proportions of patients received mealtime assistance when required (∼84%, P=0.928). Feeding assistance nearly doubled post-PMP implementation (15-29%, P=0.002). Interruptions by nursing staff increased by 8% post-PMP implementation (P<0.001) and represented 61% of all interruptions. Interruptions were less likely to occur pre-PMP implementation (odds ratio, 0.403, 95% confidence interval, 0.301-0.539). Mealtime energy and protein intakes were not changed post-PMP (P=0.979, P=0.482, respectively).
  
  
  CONCLUSIONS
  The PMP increased nursing staff availability at mealtimes and feeding assistance, but also increased mealtime interruptions. This may explain the lack of change in patient energy and protein consumption. Strategies promoting adherence with PMP implementation, such as nurse ward champions or nursing staff driving PMP implementation, may be required to maximise the benefits of protected mealtimes.
authors.affiliation: Department of Nutrition and Dietetics, Logan Hospital, Queensland Health, Meadowbrook, Queensland, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Huxtable
authors.forename: M
authors.initials: M
authors.lastname: Palmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005521:Food Service, Hospital; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D062407:Meals; D008875:Middle Aged; D009740:Nursing Staff; D005791:Patient Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D004044:Dietary Proteins