Mobilising Older Patients for Mealtimes: A Quality Improvement Project to Promote Sitting Out for Lunch

Introduction

Prolonged bed rest in older hospitalised patients can contribute to deconditioning and loss of functional independence. Mealtimes provide a practical opportunity to encourage mobilisation. This quality improvement project assessed whether education and prompting could improve sitting out for lunch among older inpatients.

Methods

Ten inpatients aged ≥65 years on a rehabilitation/geriatric ward were observed over three consecutive days. Patients were assessed for their ability and clinical suitability to sit out for lunch. Where appropriate, patients who remained in bed were provided with education and encouragement regarding mobilisation at mealtimes. Sitting out for lunch was subsequently recorded over the three-day period.

Results

Six female and four male patients were included. Among the six female patients, two sat out for lunch on all three days. One medically fit patient remained in bed on day 1 because of staff shortage but sat out on days 2 and 3. One patient remained in bed for the first two days but, following repeated prompting and education, sat out on day 3. Two further patients did not sit out on day 1 but, following education, sat out for lunch on both subsequent days.

Among the four male patients, two sat out for lunch on all three days. One initially remained in bed but sat out following education from day 1 onwards. One patient had lunch in bed because of tiredness and heavy legs.

Overall, 4/10 (40%) patients were consistently sitting out without requiring improvement, while 4/10 (40%) demonstrated improved mealtime mobilisation following education, prompting and/or resolution of a staffing barrier. One patient’s mobilisation was limited by symptoms.

Conclusion

This small quality improvement project suggests that simple interventions, including patient education, repeated prompting and attention to practical staffing barriers, can improve mobilisation at mealtimes in older inpatients. Incorporating encouragement to sit out for meals into routine multidisciplinary ward practice may provide a simple opportunity to reduce prolonged bed rest and support maintenance of function. Further cycles with a larger patient group would help assess whether improvements are sustained.