Implementation of a Mealtime Assistance Training Program for Long Term Care Staff

Abstract

Problem: In nursing homes approximately 70% of residents have a form of dementia and are at risk of malnourishment. Long-term care (LTC) facility residents have varying degrees of cognitive impairment affecting their capacity to feed themselves. The director of nursing at the project site identified that residents are vulnerable to decreased food and fluid intake, which may be reflective of limited feeding skills of the nursing staff. Purpose: The purpose of this quality improvement project was to implement an online staff training program for handfeeding of residents with cognitive impairment (CI) in a LTC facility to optimize the mealtime interaction and improve resident health outcomes. Methods: The project was implemented at a LTC facility in rural Maryland with nine staff participants (2 nurses and 7 geriatric nursing assistants), who worked shifts while meals were served. Data collection occurred through pre- and post-training surveys as well as baseline and final (end-of-project) interviews to evaluate the staff’s perception of improvements in the mealtime interaction and enhanced outcomes for residents. Results: Prior to the training, only 11.1% of the staff reported ever having any formal training/education on feeding assistance beyond their basic nursing educational program. All the staff completed the training program and corresponding skill competency checklists. While 100% of the staff reported via the surveys the training as being helpful, only 87% had the opportunity to use any of the skills or techniques from the training. The primary qualitative finding from the final interviews was 100% of staff said the training has or would improve the mealtime experience and nutritional state of residents. Conclusion: The data collected from surveys and interviews confirms that staff participants found the training program for handfeeding of residents with CI to be valuable in improving feeding interactions as well as the nutritional state of residents.