Factors influencing the implementation of mealtime interventions in inpatient and aged care settings: A systematic review

Many mealtime interventions have been developed over the past ten years. The effective implementation of such interventions into clinical practice is crucial to improve the swallowing safety and/or mealtime-related quality of life for people living with dysphagia or at risk of malnutrition. This systematic review summarises and critically appraises the literature on implementation of mealtime interventions in inpatient and aged care settings. A systematic database search was conducted using CINAHL, Embase, and MEDLINE. In total, 4475 records were identified and 25 studies met the inclusion criteria. Data were extracted relating to country, healthcare setting and characteristics, number of participants, target population, research method and designi intervention implemented, framework used, implementation strategies, facilitators and barriers to implementation, intervention outcomes, and implementation outcomes. Findings highlighted gaps in the literature regarding implementation of evidence-based mealtime interventions and their associated outcomes. Staff training and engaging key stakeholders were the most used implementation strategies. Inconsistencies in the reporting of implementation processes and outcomes were identified. Further research is required to evaluate the most effective strategies for implementing mealtime interventions and the successful integration of evidence-based practices, thus enhancing the quality of care and the well-being of individuals experiencing dysphagia.