title: Optimizing protein and energy intake in hospitals by improving individualized meal serving, hosting and the eating environment.
abstract: OBJECTIVE
  Optimizing protein and energy intake by food in nutritional risk patients is difficult. The aim of this study was to improve the ≥75% of energy and protein requirements. We would like to see nurses take on the role of hosting the nutritional-risk patients, including focusing on bringing nutrition to the forefront in the collaboration between nurses and patients.
  
  
  METHODS
  This was an interventional study that included patients admitted to the Departments of Infectious Diseases, Hematology, and Heart-Lung Surgery in a baseline and follow-up investigation. It included 24-h food intake registrations (FRs) for 3 d consecutively, a questionnaire, and a semistructured patient interview. The interventions included in this study helped to improve the eating environment and serving, integrated nutrition into the nurse-patient welcome interview, and targeted individual preferences and challenges for eating.
  
  
  RESULTS
  The study comprised 76 24-h FRs at baseline and 108 FRs at follow-up. The total group had improved food intake; 75% of individual energy requirements were met by (67.6% vs. 40%; P = 0.036) and the Heart-Lung Surgery group (85.7 vs. 38.5; P = 0.036). This was not reflected for protein (NS). Energy intake improved for the entire group, albeit not significantly (P = 0.862). Patients reported being happy with the interventions regarding individualized food serving, nurse communication, and improved meal environments.
  
  
  CONCLUSIONS
  Only insignificant improvements to overall energy intake were seen in two of the three departments and in the overall group, and no statistical or clinically significant improvements to protein intake were observed. The relative risk of meeting 75% of energy requirements was improved in the overall group and in patients in the Department of Heart-Lung Surgery. This did not include the meeting of protein requirements. Improvements were welcomed by patients and staff. Focus on individualized nutrition from the nursing staff also improved.
authors.affiliation: Centre for Nutrition and Bowel Disease, Aalborg University Hospital and Aalborg University, School of Medicine and Health, Aalborg, Denmark. Electronic address: mette.holst@rn.dk.
authors.forename: Mette
authors.initials: M
authors.lastname: Holst
authors.affiliation: Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Beermann
authors.affiliation: Aalborg Central Hospital Kitchen, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Marie Nerup
authors.initials: MN
authors.lastname: Mortensen
authors.affiliation: Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Lotte Boa
authors.initials: LB
authors.lastname: Skadhauge
authors.affiliation: Centre for Nutrition and Bowel Disease, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Køhler
authors.affiliation: Skills and Simulation Unit, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Karen
authors.initials: K
authors.lastname: Lindorff-Larsen
authors.affiliation: Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Henrik Højgaard
authors.initials: HH
authors.lastname: Rasmussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D005521:Food Service, Hospital; D006761:Hospitals; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D062407:Meals; D008875:Middle Aged; D009751:Nutritional Requirements; D057240:Patient Preference; D017060:Patient Satisfaction; D012307:Risk Factors
chemical_list: D004044:Dietary Proteins
keywords: Hospitalized patients; Meals; NRS-2002; Nurses; Nutrition intake; Serving