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Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002–2003

Abstract

Background:

Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes.

Aim:

The purpose of this study was to investigate whether the increased focus on nutritional problems in patients and nursing home residents has resulted in measurable progress.

Design:

A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n=96) and nursing homes (n=898) in 1995 and 2002/3 (n=90) and (n=682), respectively. The study used compliance with selected issues in the official Danish recommendations for institutional food service as an indicator for progress. The issues included: using nutrient calculated recipes/menus, offering menu choice options, using feedback routines on acceptability of menus, maintaining nutritional steering committees, employing food and nutrition contact persons, employing official recommendations and offering choice between three different menu energy levels.

Results:

Hospitals had a higher compliance compared to nursing homes. In 1995, this was the case for all questions asked and differences were statistically significant. Also in 2002/3, hospitals had a higher compliance, except in the case of established feedback routines. Differences were statistically significant. The results indicate that nutritional care is higher on the agenda in hospital, than in nursing homes. However, very little progress can be seen in compliance when results are analysed over the 8-year period. The only progress for nursing homes was that more homes had implemented feedback routines on acceptability of food service in 2002/3 than in 1995. The difference was statistically significant. For hospitals, however, no progress was found between 1995 and 2002/3.

Conclusion:

The attempts to improve the nutritional status of hospital patients and nursing home residents seem to have failed. Still, the initiatives taken to improve the situation seem relevant. Especially the nursing homes might benefit from advantage of these experiences.

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References

  • Anonymous (2001). Better food for the elderly, Ministry of Food, Agriculture and Fisheries/Ministry of Social Affairs (in Danish), available athttp://www.social.dk/netpublikationer/p4bm(ae)270401/bedre_mad.pdf.

  • Anonymous (2003). Bettter food for the sick – Why and how. National Board of Health/National Food Agency (in Danish), available atwww.bedremadtilsyge.sst.dk.

  • Almdal T, Viggers L, Beck AM, Jensen K (2003). Food production and wastage in relation to nutritional intake in a general district hospital – wastage is not reduced by training of staff members. Clin Nutr 22, 47–51.

    Article  CAS  Google Scholar 

  • Bates CJ, Benton D, Biesalski HK, Staehelin HB, Van Staveren W, Stehle P et al. (2002). Nutrition and aging: a consensus statement. J Nutr Health Aging 6, 103–116.

    CAS  PubMed  Google Scholar 

  • Beck AM, Balknäs UN, Camilo ME, Fürst P, Gentile MG, Hasunen K et al. (2003). The European view of hospital undernutrition. Nutr Clin Pract 18, 247–249.

    Article  Google Scholar 

  • Beck AM, Ovesen L, Schroll M (2002). Home-made oral supplement as nutritional support of old nursing home residents, who are undernourished or at risk of undernutrition based on the MNA. A pilot trial. Aging Clin Exp Res 14, 212–215.

    Article  Google Scholar 

  • Beck AM, Ovesen L (2002). Body mass index, weight loss and energy intake of old Danish nursing home residents and home-care clients. Scand J Caring Sci 16, 86–90.

    Article  Google Scholar 

  • Beck AM, Ovesen L (2004). The effect of diet modification on dietary intake, and body weight of elderly nursing home residents formerly receiving chopped or blended diets. A pilot trial. J Food Serv Res Int 14, 211–221.

    Article  Google Scholar 

  • Council of Europe (2002). Food and Nutritional Care in Hospitals: How to Prevent Undernutrition. Council of Europe Publishing: Strasbourg.

  • Green CJ (1999). Existence, causes and consequences of disease-related undernutrition in the hospital and the community, and clinical and financial benefits of nutritional intervention. Clin Nutr 18 (Suppl 2), 3–28.

    Google Scholar 

  • Hessov I (1977). Energy and protein intake in elderly patients in an orthopaedic surgical ward. Acta Chir Scand 143, 145–149.

    CAS  PubMed  Google Scholar 

  • Johansen NN, Kondrup J, Plum LM, Bak L, Norregaard P, Bunch E et al. (2004). Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 23, 539–550.

    Article  Google Scholar 

  • Kondrup J (2001). Can food intake in hospitals be improved. Clin Nutr 20 (Suppl 1), 153–160.

    Article  Google Scholar 

  • Kondrup J, Bak L, Hansen BS, Ipsen B, Ronneby H (1998). Outcome from nutritional support using hospital food. Nutrition 14, 319–321.

    Article  CAS  Google Scholar 

  • Kondrup J, Johansen N, Plum LM, Bak L, Højlund Larsen I, Martinsen A et al. (2002). Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clin Nutr 21, 461–468.

    Article  CAS  Google Scholar 

  • Kristensen NH, Thorsen AV, Engelund E, Dahl A, Mikkelsen BE (2005). Innovation, management and sustainability – change processes in the food service sector. In: Edwards JSA(ed). Global and National Perspectives, Conference Proceedings of Fifth International Conference on Culinary Arts and Sciences, Bournemouth University: Bournemouth. pp 12–16.

    Google Scholar 

  • Lassen KO, Kruse F, Bjerrum M, Jensen L, Hermansen K (2004). Nutritional care of Danish medical inpatients: effect on dietary intake and the occupational groups' perspectives of intervention. Nutr J 3, 1–13.

    Article  Google Scholar 

  • Lassen KO, Olsen J, Grinderslev E, Kruse F, Bjerrum M (2006). Nutritional care of medical inpatients: a health technology assessment. BMC Health Services Res, 6, 7.

  • Mikkelsen BE (2004). Are traditional food service organisations ready for organisational change? – a case study of implementation of environmental management in a work place canteen facility. J Food Serv Res Int 15, 89–106.

    Article  Google Scholar 

  • Mikkelsen BE, Beck AM, Balknäs UB, Camilo ME, Fürst P, Gentile MG et al. (2003). What can food service operators do to remedy undernutrition in hospitals? – a European perspective from an ad hoc group on Nutrition Programmes in Hospitals, Council of Europe. J Food Serv Res Int 13, 269–278.

    Article  Google Scholar 

  • O'Flynn J, Peake H, Hickson M, Foster D, Frost G (2005). The prevalence of malnutrition in hospitals can be reduced: results from three consecutive cross-sectional studies. Clin Nutr 24, 1078–1088.

    Article  Google Scholar 

  • O'Loughlin J, Renaud L, Richard L, Sanchez Gomez L, Paradis G (1998). Correlates of the sustainability of community-based heart health promotion interventions. Prev Med 27, 702–712.

    Article  CAS  Google Scholar 

  • Pedersen A, Ovesen L (Eds.) (2000). Recommendations Regarding the Food Served in Danish Institutions, Danish Veterinary and Food Administration (in Danish) Søborg, Denmark.

  • Rasmussen HH, Kondrup J, Staun M, Ladefoged K, Kristensen H, Wengler A (2004). Prevalence of patients at nutritional risk in Danish hospitals. Clin Nutr 23, 1009–1015.

    Article  Google Scholar 

  • Stellfeld M, Gyldendorf B (1988). Dietary investigation in a general medical ward. The energy, protein and zinc intakes of fifty-six patients during a period of hospitalisation. J Dan Med Assoc 150, 1537–1540.

    CAS  Google Scholar 

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Correspondence to B E Mikkelsen.

Additional information

Guarantor: BE Mikkelsen.

Contributors: BEM and AL co-developed the first questionnaire. AL and AMB developed the second questionnaire based on the first questionnaire and computed the data. AMB wrote the first draft and all authors co-refined it into a manuscript and BEM did the final editing.

Appendix 1

Appendix 1

The appendix shows the identical parts of the hospital and nursing homes questionnaires in the 1995 and the 2002/2003 study.

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Mikkelsen, B., Beck, A. & Lassen, A. Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002–2003. Eur J Clin Nutr 61, 129–134 (2007). https://doi.org/10.1038/sj.ejcn.1602488

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