No longer hungry in hospital: improving the hospital mealtime experience for older people through action research

Aims and objectives. This study aimed to improve the mealtime experience of older people in a hospital setting through helping staff to make changes to their clinical practice and the ward environment. Background. Poor nutritional care has been a persistent and seemingly intractable problem for many years. Methods. We used an action research design for the study, drawing on techniques from practice development to support the action phase of the work, including action learning, role modelling good practice and reflection. The ward context was explored at the beginning and end of the study using focus groups, interviews, observation and benchmarking. Results. Ward staff made a number of changes to their nursing practice. The most significant was that all staff became engaged with, prioritized and were involved in the mealtime, ensuring that there was sufficient time and expertise available to assist patients with eating. Conclusions. This study demonstrates that it is possible to change nursing practice at mealtimes and that this change leads to improvements in patients' experience through ensuring they receive the help they need. Relevance to clinical practice. Although hospital mealtimes are frequently viewed as problematic, we have shown that nurses can be enabled to make changes to their practice that have a positive impact on both the mealtime experience and wider patient care.