• nursing homes;
  • nutrition;
  • supplementation;
  • quality

OBJECTIVES: To describe nursing home (NH) staff delivery of oral liquid nutritional supplements to residents with an order to receive supplementation.

DESIGN: Descriptive.

SETTING: Six skilled NHs.

PARTICIPANTS: One hundred thirty-two long-stay residents.

MEASUREMENTS: Research staff conducted direct observations for 2 days during and between meals and documented NH staff delivery of supplements, amount consumed (fluid ounces), and amount of assistance (minutes) provided by staff to encourage consumption.

RESULTS: Eighty-eight percent had an order to receive a supplement one to three times daily (mode=3); 12% had an order to receive a supplement four to six times daily. Fewer than 10% received the supplement consistent with their orders during the 2 observation days. On average, NH staff provided a supplement less than once per participant per day during or between meals. When a supplement was provided, residents consumed an average±standard deviation of 4.91±2.19 fluid ounces during meals with 6.16±7.46 minutes of staff assistance and 3.98±2.60 fluid ounces between meals with less than 1 minute of staff assistance. Participants with orders that specified time of delivery received the supplement at a significantly higher frequency between meals.

CONCLUSION: Oral liquid nutritional supplements are not provided consistent with orders in NH practice. Staff spends little time promoting supplement consumption during or between meals. The specificity of the order related to time of delivery may influence when and how often supplements are provided to residents.