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EAT NOW: Implementing a Sustainable Patient Protected Mealtime Program

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This presentation was delivered at the Quality Forum 2016 by Theresa Cividin, Jacqueline Per, and Stephanie Yurchuk.

For more information, visit www.QualityForum.ca

Published in: Healthcare
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EAT NOW: Implementing a Sustainable Patient Protected Mealtime Program

  1. 1. EAT NOW: Implementing a Sustainable Patient Protected Mealtime Program Theresa Cividin, Practice Leader Clinical Nutrition, VA Jacqueline Per, Director Quality & Patient Safety, Vancouver Stephanie Yurchuk, BSN Student, Langara College Quality Forum 16 February 25, 2016
  2. 2. Background Summary of VGH Data 34 % subjects malnourished upon admission 29% subjects had intakes less than 50% Intakes of greater than 50% are associated with early discharge 2
  3. 3. “By removing non-essential staff interruptions and pausing non-essential tasks, health care staff can help clients with hand hygiene, meal set-up, and provide extra assistance to those in need.” (Agarwal et al, 2012) Protected Mealtimes 3
  4. 4. Baseline Audit – May 2014 (n=136) • Pt hand hygiene – 0% • Good positioning – 74% • Bedside table – 80% • Interruptions – 163 • <50% intake – 28% Wave One: Baseline and Education 4
  5. 5. Wave One Outcomes Engage Stakeholders • Unit Leadership • All unit staff • Support staff: Sodexo and Aramark • Physicians/residents Staff Education • Introduce Protected Mealtime • EAT NOW (Easy Access to Nutrition on Wards) • Plan for patient hand hygiene • Posters on unit and in patient rooms 5
  6. 6. 6
  7. 7. Wave Two: Implementation • Pt hand hygiene – 0% • Good positioning – 74% • Bedside table – 80% • Interruptions – 163 • <50% intake – 28% • Pt hand hygiene – 56% • Good positioning – 100% • Bedside table – 99% • Interruptions – 47 • <50% intake – 16% Baseline - May 2014 (n=136) Post - Oct 2014 (n=146) 7
  8. 8. • To improve staff attitudes towards menu items – Sample menu items and different food textures from the patient menu • Relationship building with the Food Services Management team Food Tasting Events 8
  9. 9. Wave Three: Evaluation Pt hand hygiene – 0% Good positioning – 74% Bedside table – 80% Interruptions – 163 <50% intake – 28% Pt hand hygiene – 56% Good positioning – 100% Bedside table – 99% Interruptions – 47 <50% intake – 16% Baseline - May 2014 (n=136) Post - Oct 2014 (n=146) Post – June 2015 (n=127) Pt hand hygiene – 55% Good positioning – 84% Bedside table – 96% Interruptions – 77 <50% intake – 12% 9
  10. 10. Sustainability Phase • Unit Orientation (patients, visitors, staff) • Hand Hygiene: sani wipes provided on meal trays • Continued Food Tasting Events 10
  11. 11. 11 What the staff (n=12) said: Interruptions: - non-emergent tests and procedures, blood collection, doctor and family meetings Barriers to PPM implementation: - late diet orders, workload, testing and procedures, competing hospital resources Nutrition in relation to patient’s health: - extremely important Further support: - more staff, test times to change, staffing and organization “Maybe we can include the cleaning wipes with the meal tray” “I Feel that nutrition is incredibly undervalued” 11
  12. 12. 12 What the patients (n=22) said: - received mealtime assistance - received a menu to mark - those who required assistance with menu selections received it - Only one patient reported being distracted from eating (Pain) “The nurse always came in to help me eat” “The staff was very helpful and kind” “The food was delicious” 12
  13. 13. Next Steps • Incorporate PPM into VCH orientation • Incorporate into the patient information packages • Continue to improve compliance to patient hand hygiene • Continue to explore diagnostic testing/phlebotomy options • Expand to other units at VGH 13
  14. 14. Acknowledgements A special thank you to the Langara College Nursing students for their leadership and hard work with the project: • Carly Irons • Erica Dovan • Kalin Li • Vivian Dinh • Raluca Antonovici • Stephanie Yurchuk • Dr. Veryl Tipliski, Nurse Educator, Langara School of Nursing 14

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