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Menu Planning Plate Website Assists Children to Healthier Eating
MONDAY, OCTOBER 21
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Quality Improvement: A Before and After Look at the Implementation of Country Kitchen Style Service in a Long Term Care Setting
Menu Planning Plate Website Assists Children to Healthier Eating
Author: M.K. Howell; Nutrition Services, Masonic Villages, Elizabethtown, PA
Author(s): M.D. Condrasky, E. Dixon; Food Science and Human Nutrition, Clemson Univ., Clemson, SC
Learning Outcome: Participant will be able to identify four parameters that were studied and their respective outcomes/impact.
Learning Outcome: Participant will be able to apply web menu planning technique for pre-adolescent audience.
Background: My Long Term Care facility wanted to evaluate the impact of change of service from a traditional trayline to table side (country kitchen) style. The transition was spread over an 11 month time frame in 7 neighborhoods. Did residents “eat better” as was hypothesized? Did supplement usage decrease; in doing so, what were the weight and nutritional markers?
This study conducted at a summer cooking camp analyzed the cooking and menu planning self-efficacy of pre-adolescent children and to determine if these skills could influence healthier eating habits. A convenience sample of 53 children (ages 10-14) participating in two sessions of the University 2011 Cook Like a Chef camp used a newly designed Menu Planning Plate website throughout the week of camp to plan meals and reinforce general nutrition concepts. Children were asked separate questions on whether they believed planning their meals would increase their intake of vegetables and/or their intake of fruits. They were asked how many additional servings of fruits and vegetables they believed they would eat if they planned their meals. The average estimated increase for servings of fruits and vegetables was determined with more servings of fruit to be eaten if the meals for the day were planned (p-value ¼ 0.4997, standard deviation ¼ 0.882). Participants demonstrated a significant increase in confidence to plan a meal, a days’ worth of meals, and a week's worth of meals following their experiences with the web tool (p<0.0001). Participants were asked several items that were only on the post-questionnaire. Almost two-thirds of the participants (64.71%) said they were completely confident in their ability to plan a meal using the website tool with MyPlate guidelines. The majority indicated it as easy to use and that they would use the tool after camp. Teaching children how to plan and cook their own meals could increase their likelihood of choosing healthy foods.
Method: Four aspects were reviewed for each neighborhood. 1. Average meal percentage for a week before and after transition. 2. Use of supplements before transition, immediately after transition, and 3 months after transition. 3. Weight status of residents before transition (stability over 1 quarter) and after 6 months (stability over 1 quarter and 2 quarters). 4. Impact on protein and blood sugar labs before transition compared to after transition. Results: Meal percentages did increase. This data is peripherally useful since it is very subjective and does not recognize a small order/high intake % compared to a larger order/low intake %. Supplement dollars spent decreased by 34-44% depending on the neighborhood. Weights and weight trends remained stable over time, after an initial upswing. Lab markers showed more stability than anticipated, even with more liberalizing of diet orders and more choices. Conclusion: Overall, the transition to country kitchen style of meal service was very successful. A few new opportunities arose regarding hydration, production shifts, milk consumption, and vegetable intake. In addition to the positive data, the soft markers of increased choice by residents cannot be underestimated.
Funding Disclosure: None
Funding Disclosure: None
Improving Productivity and Labor Efficiency in the Hospital - The Issue of Late Trays
CMS Conditions of Participation: Meeting Dietary Reference Intakes on The Patient Menu
Author(s): A. Wagle1, J. Locquiao1, L. McProud1, A. Cooley2; 1Nutrition, Food Science and Packaging, San Jose State Univ., San Jose, CA, 2El Camino Hosp., Mountain View, CA
Author(s): R. Maghen, C. Rainville; Food and Nutrition Services, Morrison Management Specialists, Los Angeles, CA
Learning Outcome: Participants will be able to improve productivity and reduce the number of late trays by adopting the interventions specified. The purpose of the study was to improve the productivity and labor efficiency of the hospital by reducing the number of late trays and to investigate the reasons for late trays. A quantitative post-intervention study design was used with the nutrition and nursing staff based on the number of late trays issued. Baseline retrospective data was analyzed from July - August 2010 for an 8-week period, while the intervention data was collected from November 2010 to January 2011. Interventions included: (1) reminding nursing of specific floor mealtimes; (2) placing reminder containing specific times to update diet orders and tips to prevent late trays on hospital units; (3) holding off automatically sending a new tray when a patient's diet order changed unless they were previously having nothing by mouth (NPO) or if a nurse or host specifically requested for a second tray; and (4) Educate/Inservice foodservice staff, hosts, clerks, and nurses on the importance of mealtimes. The number of late trays identified during the 16-week study on three acute units: Surgical/Pediatrics, Medical/Surgical Oncology, and Medical was 2,155 with 1,060 pre-intervention and 1,095 late trays post-intervention. The Surgical/Pediatrics was the only unit that had a decrease in the number of late trays (379 pre-intervention and 347 post-intervention). The use of reminders through notes, holding new trays, and late tray awareness through surveys did not result in a significant decrease in the number of late trays. Education of meal times did increase awareness of late tray requests but most likely had null effect. Funding Disclosure: None
Learning Outcome: To identify nutrients for which meeting the Dietary Reference Intakes (DRIs) on the standard regular patient menu is challenging, and to determine food types, quantities and frequencies that assist with meeting the DRIs. The Centers for Medicare & Medicaid Services (CMS), establishes criteria, or Conditions of Participation (CoPs), that healthcare organizations must meet to qualify for, and participate in, Medicare and Medicaid programs. Hospitals are routinely surveyed to ensure that CoPs are met; if not met, hospitals risk losing funding. Food & Nutrition plays an integral role in ensuring that several CoPs are met, by implementing patient menus that follow national standards for recommended dietary allowances (eg, Dietary Reference Intakes DRIs) (DHHS & CMS. Rev. 2011. State Operations Manual: Appendix A e Survey Protocol, Regulations and Interpretive Guidelines for Hospitals. Retrieved from: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/ Downloads/som107ap_a_hospitals.pdf). Twenty-seven California hospitals were surveyed to determine nutrients challenging to meet DRIs on standard regular patient menus. Survey results showed 93% of hospitals had difficulty meeting potassium, vitamin E and vitamin D requirements; challenges were also noted in meeting fiber (82% of hospitals), and choline and magnesium requirements (67% of hospitals). A nutrient analysis software that incorporates information from the USDA National Nutrient Database was used to determine key food types, quantities and frequencies to assist with meeting DRIs for challenging nutrients. Examples include supplementing meals with Promise margarine, increasing frequency of low fat milk, and increasing portions of steamed vegetables and fresh fruits. Other examples include incorporating hot- and fortified cold-cereals, using specific whole grains, and selecting potato- and bean-based recipes and fruit-based desserts. Moreover, inclusion of such food items can assist with ensuring 100% compliance with DRIs for all macro and micronutrients. Funding Disclosure: None
A-58
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2013 Suppl 3—Abstracts Volume 113 Number 9
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Quality Improvement: A Before and After Look at the Implementation of Country Kitchen Style Service in a Long Term Care Setting
Menu Planning Plate Website Assists Children to Healthier Eating
Author: M.K. Howell; Nutrition Services, Masonic Villages, Elizabethtown, PA
Author(s): M.D. Condrasky, E. Dixon; Food Science and Human Nutrition, Clemson Univ., Clemson, SC
Learning Outcome: Participant will be able to identify four parameters that were studied and their respective outcomes/impact.
Learning Outcome: Participant will be able to apply web menu planning technique for pre-adolescent audience.
Background: My Long Term Care facility wanted to evaluate the impact of change of service from a traditional trayline to table side (country kitchen) style. The transition was spread over an 11 month time frame in 7 neighborhoods. Did residents “eat better” as was hypothesized? Did supplement usage decrease; in doing so, what were the weight and nutritional markers?
This study conducted at a summer cooking camp analyzed the cooking and menu planning self-efficacy of pre-adolescent children and to determine if these skills could influence healthier eating habits. A convenience sample of 53 children (ages 10-14) participating in two sessions of the University 2011 Cook Like a Chef camp used a newly designed Menu Planning Plate website throughout the week of camp to plan meals and reinforce general nutrition concepts. Children were asked separate questions on whether they believed planning their meals would increase their intake of vegetables and/or their intake of fruits. They were asked how many additional servings of fruits and vegetables they believed they would eat if they planned their meals. The average estimated increase for servings of fruits and vegetables was determined with more servings of fruit to be eaten if the meals for the day were planned (p-value ¼ 0.4997, standard deviation ¼ 0.882). Participants demonstrated a significant increase in confidence to plan a meal, a days’ worth of meals, and a week's worth of meals following their experiences with the web tool (p<0.0001). Participants were asked several items that were only on the post-questionnaire. Almost two-thirds of the participants (64.71%) said they were completely confident in their ability to plan a meal using the website tool with MyPlate guidelines. The majority indicated it as easy to use and that they would use the tool after camp. Teaching children how to plan and cook their own meals could increase their likelihood of choosing healthy foods.
Method: Four aspects were reviewed for each neighborhood. 1. Average meal percentage for a week before and after transition. 2. Use of supplements before transition, immediately after transition, and 3 months after transition. 3. Weight status of residents before transition (stability over 1 quarter) and after 6 months (stability over 1 quarter and 2 quarters). 4. Impact on protein and blood sugar labs before transition compared to after transition. Results: Meal percentages did increase. This data is peripherally useful since it is very subjective and does not recognize a small order/high intake % compared to a larger order/low intake %. Supplement dollars spent decreased by 34-44% depending on the neighborhood. Weights and weight trends remained stable over time, after an initial upswing. Lab markers showed more stability than anticipated, even with more liberalizing of diet orders and more choices. Conclusion: Overall, the transition to country kitchen style of meal service was very successful. A few new opportunities arose regarding hydration, production shifts, milk consumption, and vegetable intake. In addition to the positive data, the soft markers of increased choice by residents cannot be underestimated.
Funding Disclosure: None
Funding Disclosure: None
Improving Productivity and Labor Efficiency in the Hospital - The Issue of Late Trays
CMS Conditions of Participation: Meeting Dietary Reference Intakes on The Patient Menu
Author(s): A. Wagle1, J. Locquiao1, L. McProud1, A. Cooley2; 1Nutrition, Food Science and Packaging, San Jose State Univ., San Jose, CA, 2El Camino Hosp., Mountain View, CA
Author(s): R. Maghen, C. Rainville; Food and Nutrition Services, Morrison Management Specialists, Los Angeles, CA
Learning Outcome: Participants will be able to improve productivity and reduce the number of late trays by adopting the interventions specified. The purpose of the study was to improve the productivity and labor efficiency of the hospital by reducing the number of late trays and to investigate the reasons for late trays. A quantitative post-intervention study design was used with the nutrition and nursing staff based on the number of late trays issued. Baseline retrospective data was analyzed from July - August 2010 for an 8-week period, while the intervention data was collected from November 2010 to January 2011. Interventions included: (1) reminding nursing of specific floor mealtimes; (2) placing reminder containing specific times to update diet orders and tips to prevent late trays on hospital units; (3) holding off automatically sending a new tray when a patient's diet order changed unless they were previously having nothing by mouth (NPO) or if a nurse or host specifically requested for a second tray; and (4) Educate/Inservice foodservice staff, hosts, clerks, and nurses on the importance of mealtimes. The number of late trays identified during the 16-week study on three acute units: Surgical/Pediatrics, Medical/Surgical Oncology, and Medical was 2,155 with 1,060 pre-intervention and 1,095 late trays post-intervention. The Surgical/Pediatrics was the only unit that had a decrease in the number of late trays (379 pre-intervention and 347 post-intervention). The use of reminders through notes, holding new trays, and late tray awareness through surveys did not result in a significant decrease in the number of late trays. Education of meal times did increase awareness of late tray requests but most likely had null effect. Funding Disclosure: None
Learning Outcome: To identify nutrients for which meeting the Dietary Reference Intakes (DRIs) on the standard regular patient menu is challenging, and to determine food types, quantities and frequencies that assist with meeting the DRIs. The Centers for Medicare & Medicaid Services (CMS), establishes criteria, or Conditions of Participation (CoPs), that healthcare organizations must meet to qualify for, and participate in, Medicare and Medicaid programs. Hospitals are routinely surveyed to ensure that CoPs are met; if not met, hospitals risk losing funding. Food & Nutrition plays an integral role in ensuring that several CoPs are met, by implementing patient menus that follow national standards for recommended dietary allowances (eg, Dietary Reference Intakes DRIs) (DHHS & CMS. Rev. 2011. State Operations Manual: Appendix A e Survey Protocol, Regulations and Interpretive Guidelines for Hospitals. Retrieved from: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/ Downloads/som107ap_a_hospitals.pdf). Twenty-seven California hospitals were surveyed to determine nutrients challenging to meet DRIs on standard regular patient menus. Survey results showed 93% of hospitals had difficulty meeting potassium, vitamin E and vitamin D requirements; challenges were also noted in meeting fiber (82% of hospitals), and choline and magnesium requirements (67% of hospitals). A nutrient analysis software that incorporates information from the USDA National Nutrient Database was used to determine key food types, quantities and frequencies to assist with meeting DRIs for challenging nutrients. Examples include supplementing meals with Promise margarine, increasing frequency of low fat milk, and increasing portions of steamed vegetables and fresh fruits. Other examples include incorporating hot- and fortified cold-cereals, using specific whole grains, and selecting potato- and bean-based recipes and fruit-based desserts. Moreover, inclusion of such food items can assist with ensuring 100% compliance with DRIs for all macro and micronutrients. Funding Disclosure: None
A-58
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2013 Suppl 3—Abstracts Volume 113 Number 9