Food Service Workers: Reliable Assessors of Food Intake in Hospitalized Patients

Publication: Canadian Journal of Dietetic Practice and Research
3 October 2018

Abstract

Early detection of malnutrition in hospitalized patients is of paramount importance. As poor food intake is a marker of malnutrition risk, a simple and accurate method to monitor intake is valuable. This quality assurance project aimed to determine if food service workers (FSW) were able to provide accurate estimates of patient intakes through visually assessing meal trays at an acute care hospital. FSW conducted visual estimates of patient trays after meals using the meal plate pictorial rating scale adapted from the My Meal Intake Tool and translated their estimates into one of 5 consumption levels (0%, 25%, 50%, 75%, or 100%). A total of 401 patient meal estimates were validated using the food weighing method. Spearman’s correlations between percent calories consumed (determined by weight) and estimates by FSW were 0.624 (n = 137, P < 0.001), 0.771 (n = 134, P < 0.001), and 0.829 (n = 130, P < 0.001), for breakfast, lunch, and supper, respectively. Paired Wilcoxon tests and the Kruskal–Wallis H test showed that accuracy varied for breakfast, lunch, and supper. The overall sensitivity and specificity of FSW for detecting patient intake ≤50% was 81% and 88%, respectively. These findings identify that FSW can accurately estimate patient intake, contributing an important marker for the detection of malnutrition.

Résumé

La détection précoce de la malnutrition chez les patients hospitalisés est d’une importance primordiale. Puisqu’un apport alimentaire insuffisant est un marqueur du risque de malnutrition, il est utile de disposer d’une méthode simple et précise pour surveiller l’apport alimentaire. Ce projet d’assurance de la qualité visait à déterminer si les travailleurs des services alimentaires (TSA) étaient en mesure de fournir des estimations précises des apports alimentaires des patients au moyen d’un examen visuel des plateaux-repas distribués dans un hôpital de soins de courte durée. Les TSA effectuaient une estimation visuelle des plateaux des patients après les repas en utilisant l’échelle d’évaluation figurative des plateaux-repas adaptée à partir de l’outil « Mon alimentation » et traduisaient leurs estimations en l’un des cinq niveaux de consommation (0 %, 25 %, 50 %, 75 % ou 100 %). Un total de 401 estimations de repas de patients ont été validées en utilisant la méthode de la pesée des aliments. Les corrélations de Spearman entre les pourcentages de calories consommées (déterminées selon le poids) et les estimations des TSA étaient de 0,624 (n = 137, P < 0,001); 0,771 (n = 134, P < 0,001); et 0,829 (n = 130, P < 0,001) pour le déjeuner, le dîner et le souper, respectivement. Les tests de Wilcoxon pour données appariées et le test H de Kruskal-Wallis ont montré que la précision variait pour le déjeuner, le dîner et le souper. Globalement, la sensibilité et la spécificité des TSA à détecter un apport alimentaire ≤ 50 % chez un patient étaient de 81 % et 88 %, respectivement. Ces résultats montrent que les TSA peuvent estimer de manière précise l’apport alimentaire d’un patient, fournissant ainsi un marqueur important pour la détection de la malnutrition.

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Financial support: Financial support for this study was provided in the form of a summer student research grant from the Department of Research and Performance Support, Regina Qu’Appelle Health Region.
Conflict of interest: The authors declare that they have no competing interests.

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Supplementary Material

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Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 80Number 1March 2019
Pages: 30 - 33

History

Version of record online: 3 October 2018

Authors

Affiliations

Heather Tulloch MSc, RD
Nutrition and Food Services and Research and Performance Support, Saskatchewan Health Authority, Regina, SK
Stephanie Cook MSc, RD
Nutrition and Food Services and Research and Performance Support, Saskatchewan Health Authority, Regina, SK
Roseann Nasser MSc, RD
Nutrition and Food Services and Research and Performance Support, Saskatchewan Health Authority, Regina, SK
Gina Guo BSc
Nutrition and Food Services and Research and Performance Support, Saskatchewan Health Authority, Regina, SK
Adam Clay MSc
Nutrition and Food Services and Research and Performance Support, Saskatchewan Health Authority, Regina, SK

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