Organisational Culture and Nutritional Care

This study adopts an action research (AR) approach given that sustained change is more likely if it incorporates authentic staff engagement. The key choice made in formulating the research design is to adopt an approach that is collaborative and participatory in a process of action and learning.

Here, eligible health practitioners involved in any aspect of the patients' food and nutritional care or helping to feed patients during mealtimes would be represented in one central team, engaging as co-researchers in the study.

Patients and/or relatives will participate in a focus group or interview session. The AR team participants will be involved in the iterative action research cycle, reflecting on current nutritional care practices, collectively evaluate patients' stories and consider ways to improve eating and drinking on the wards. The AR team will meet throughout the course of 12 months.

The study will provide insight into the impact of organisational culture ('the way the investigators do things') in the delivery of good nutritional care and elucidate the roles and responsibilities of nurses and other staff groups involved in the provision of nutritional care.

This research will provide data on the organisational culture of interdisciplinary teams working at both micro and macro levels while providing insight into the potential for AR to be used in a wider arena within the hospital to improve practice.

Inclusion criteria

• Recently discharged patients aged 65 or over
• Recently discharged patients at the time of data collection
• Who at the time of admission received oral nutrition and hydration

Exclusion criteria

• Patients aged under 65
• Current in-patients
• Patients who have had no oral nutrition. e.g patients who had Percutaneous Endoscopic Gastrostomy (PEG) feeds whilst admitted
• Patients who are feeling too unwell to participate
• Patients lacking the mental capacity to give verbal or written consent