Abstract：
BACKGROUND: Poor dietary intake is common in hospitalised older people. A targeted mealtime intervention is needed to improve nutrition care and dietary intake, especially for those at risk of malnutrition.
OBJECTIVE: This quality improvement project designed, implemented and evaluated a mealtime assistance bundle consisting of care measures driven by the hospital nursing team. The aims were to improve the mealtime care process to promote dietary intake of the hospitalised older people and to improve nursing staff\'s knowledge, attitude and practice in malnutrition.
METHODS: This project adopted a pre-post design, targeting older people aged 65 years and above, who were admitted to a general medical unit in a regional hospital in Singapore. A mealtime assistance bundle consisting of seven care measures, using the acronym CANFEED, was implemented for older adults at risk of malnutrition. Outcome measures on the amount of dietary intake during meals through chart reviews and surveys of nursing staff using Malnutrition Knowledge, Attitudes and perceived Practices (M-KAP) questionnaire were performed before and after implementation.
RESULTS: There were fewer older adults with poor intake in the post-implementation group than the pre-implementation group. Among those at risk of malnutrition, older adults in the post-implementation group had higher average intake of all provided meals as well as the protein-dense main dish. Significant improvements were noted in the total scores rated by the nursing staff in both the Knowledge-Attitude subscale and Practice subscale of the M-KAP questionnaire.
CONCLUSIONS: Integrating a nurse-driven mealtime assistance bundle into usual care may have positive outcomes on nutritional intake of hospitalised older people at risk of malnutrition, and on knowledge, attitude and practice of hospital nurses in nutrition care.
CONCLUSIONS: Nurses play a critical role in nutrition care for hospitalised older people. Continuing efforts to improve nutritional intake of hospitalised older people should focus on staff education, building a multidisciplinary food-promoting culture and patient, family and community empowerment. More efficient clinical processes incorporating information technology with the EMR to support better nutrition care of the hospitalised older people are needed.
OBJECTIVE: This quality improvement project designed, implemented and evaluated a mealtime assistance bundle consisting of care measures driven by the hospital nursing team. The aims were to improve the mealtime care process to promote dietary intake of the hospitalised older people and to improve nursing staff\'s knowledge, attitude and practice in malnutrition.
METHODS: This project adopted a pre-post design, targeting older people aged 65 years and above, who were admitted to a general medical unit in a regional hospital in Singapore. A mealtime assistance bundle consisting of seven care measures, using the acronym CANFEED, was implemented for older adults at risk of malnutrition. Outcome measures on the amount of dietary intake during meals through chart reviews and surveys of nursing staff using Malnutrition Knowledge, Attitudes and perceived Practices (M-KAP) questionnaire were performed before and after implementation.
RESULTS: There were fewer older adults with poor intake in the post-implementation group than the pre-implementation group. Among those at risk of malnutrition, older adults in the post-implementation group had higher average intake of all provided meals as well as the protein-dense main dish. Significant improvements were noted in the total scores rated by the nursing staff in both the Knowledge-Attitude subscale and Practice subscale of the M-KAP questionnaire.
CONCLUSIONS: Integrating a nurse-driven mealtime assistance bundle into usual care may have positive outcomes on nutritional intake of hospitalised older people at risk of malnutrition, and on knowledge, attitude and practice of hospital nurses in nutrition care.
CONCLUSIONS: Nurses play a critical role in nutrition care for hospitalised older people. Continuing efforts to improve nutritional intake of hospitalised older people should focus on staff education, building a multidisciplinary food-promoting culture and patient, family and community empowerment. More efficient clinical processes incorporating information technology with the EMR to support better nutrition care of the hospitalised older people are needed.
摘要：
背景：在住院的老年人中，饮食摄入不足是常见的。需要有针对性的进餐时间干预来改善营养护理和饮食摄入，尤其是那些有营养不良风险的人。
目的：这个质量改进项目的设计，实施和评估由医院护理团队推动的护理措施组成的用餐时间援助束。目的是改善用餐时护理流程，以促进住院老年人的饮食摄入，并提高护理人员的知识，营养不良的态度和做法。
方法：该项目采用了前期设计，针对65岁及以上的老年人，他们被送往新加坡一家地区医院的普通医疗机构。由七项护理措施组成的用餐时间援助包，使用缩写CANFEED，针对有营养不良风险的老年人实施。通过图表回顾和护理人员使用营养不良知识的调查，对进餐期间饮食摄入量的结果测量，在实施前后进行态度和感知实践（M-KAP）问卷。
结果：实施后组比实施前组少摄入不良的老年人。在那些有营养不良风险的人中，实施后组中的老年人在所有提供的膳食以及蛋白质密集的主菜中的平均摄入量较高.在M-KAP问卷的知识态度子量表和实践子量表中，护理人员的总分均有显着改善。
结论：将护士驱动的用餐时间援助捆绑整合到常规护理中，可能会对有营养不良风险的住院老年人的营养摄入产生积极影响。关于知识，医院护士营养护理的态度与实践。
结论：护士在住院老年人的营养护理中起着至关重要的作用。继续努力改善住院老年人的营养摄入量，应侧重于员工教育，建立多学科的食物促进文化和病人，家庭和社区赋权。需要将信息技术与EMR结合起来的更有效的临床流程，以支持住院老年人的更好的营养护理。
目的：这个质量改进项目的设计，实施和评估由医院护理团队推动的护理措施组成的用餐时间援助束。目的是改善用餐时护理流程，以促进住院老年人的饮食摄入，并提高护理人员的知识，营养不良的态度和做法。
方法：该项目采用了前期设计，针对65岁及以上的老年人，他们被送往新加坡一家地区医院的普通医疗机构。由七项护理措施组成的用餐时间援助包，使用缩写CANFEED，针对有营养不良风险的老年人实施。通过图表回顾和护理人员使用营养不良知识的调查，对进餐期间饮食摄入量的结果测量，在实施前后进行态度和感知实践（M-KAP）问卷。
结果：实施后组比实施前组少摄入不良的老年人。在那些有营养不良风险的人中，实施后组中的老年人在所有提供的膳食以及蛋白质密集的主菜中的平均摄入量较高.在M-KAP问卷的知识态度子量表和实践子量表中，护理人员的总分均有显着改善。
结论：将护士驱动的用餐时间援助捆绑整合到常规护理中，可能会对有营养不良风险的住院老年人的营养摄入产生积极影响。关于知识，医院护士营养护理的态度与实践。
结论：护士在住院老年人的营养护理中起着至关重要的作用。继续努力改善住院老年人的营养摄入量，应侧重于员工教育，建立多学科的食物促进文化和病人，家庭和社区赋权。需要将信息技术与EMR结合起来的更有效的临床流程，以支持住院老年人的更好的营养护理。
