When older adults break their hip, getting enough nutrition is crucial for healing. Researchers found that most hip fracture patients weren’t eating enough protein and calories while in the hospital. A team tested a new approach where a nutrition expert worked closely with hospital staff to improve meal planning and tracking. The results were impressive: the number of patients getting adequate nutrition jumped from 22% to 80%. This study shows that when doctors, nurses, and nutrition specialists work together and pay closer attention to what patients eat, older adults recover better from serious injuries.

The Quick Take

  • What they studied: Whether having a nutrition expert work directly with hospital staff could help older patients with hip fractures eat enough food to heal properly
  • Who participated: Older adults admitted to a hospital orthopedic ward with hip fractures who were at risk for poor nutrition. The study included about 19 patients total (9 before improvements, 10 after)
  • Key finding: After the nutrition expert joined the team and staff made improvements, 80% of patients got enough calories and protein—compared to only 22% before. This was a significant improvement that happened in just a few months
  • What it means for you: If you or a loved one has a hip fracture, asking for a nutrition specialist and making sure meals meet your needs could help you heal faster. However, this was a small study at one hospital, so talk with your doctor about what’s best for your situation

The Research Details

This was a quality improvement study, which is different from a typical research experiment. Instead of comparing two groups randomly, the researchers worked with one hospital ward to make step-by-step improvements to how they handle nutrition care. They started by measuring what was happening before any changes (baseline). Then they made two rounds of improvements: first, they focused on better documenting what patients were eating, and second, they worked on actually increasing how much patients ate. They measured results after each round to see if things got better.

The study took place over four months (September to December 2024) at an orthopedic ward. A nutrition expert (called a dietitian) was assigned to work directly with the ward staff, helping them understand why nutrition matters and teaching them better ways to help patients eat well. This is sometimes called ’embedding’ a specialist into the team.

Quality improvement studies are valuable because they test real-world solutions in actual hospital settings. Instead of just studying a problem, researchers actually try to fix it and measure whether the fix works. This approach is practical and shows what’s possible when teams commit to change. The Model for Improvement used here is a proven method that breaks big changes into smaller, manageable steps.

Strengths: The study showed clear improvements with statistical significance (meaning the changes were unlikely due to chance). The approach was systematic and well-documented. Limitations: This was a small study at one hospital with only 19 patients total, so results may not apply everywhere. There was no comparison group, so we can’t be 100% certain the improvements were only due to the dietitian’s involvement. The study was short (4 months), so we don’t know if improvements lasted long-term.

What the Results Show

The main goal was to get at least 80% of patients meeting their individual nutrition needs (enough calories and protein). Before the changes, only 22% of patients were getting adequate nutrition. After the dietitian joined the team and improvements were made, 80% of patients met their nutrition goals—exactly hitting the target. This represents a nearly four-fold improvement.

The researchers also tracked how well staff were screening patients for nutrition problems. Before the program, only 10% of patients were formally screened for nutrition risk. After the improvements, 80% were screened. This means staff became much better at identifying who needed extra nutrition support.

Documentation (writing down what patients ate) also improved dramatically. Before, only 30% of at-risk patients had their food intake recorded in medical records. After the program, 100% of patients had this documentation. This matters because when doctors and nurses can see what patients are eating, they can make better decisions about care.

Beyond the main findings, the study showed that having a nutrition expert embedded in the ward helped staff understand nutrition’s importance. The two-step improvement process (first fixing documentation, then increasing actual intake) worked well. This suggests that sometimes you need to get the basics right (tracking what’s happening) before you can make bigger changes (actually improving what patients eat). The study also demonstrated that the Model for Improvement framework was practical and achievable in a busy hospital setting.

Previous research has shown that malnutrition (not eating enough) is common in hospitalized older adults and slows healing. This study adds to that knowledge by showing that the problem isn’t just about patients not wanting to eat—it’s also about hospital systems not being set up to help them eat well. By showing that simple organizational changes (adding a nutrition expert and better tracking) can dramatically improve outcomes, this study suggests that many hospitals might be able to do better with their current resources.

The study was small with only 19 patients, so results might not apply to all hospitals or all types of patients. It was conducted at one hospital, which may have different resources or staff than other facilities. The study lasted only four months, so we don’t know if improvements continued after the program ended or if patients had better long-term recovery. There was no control group (a similar ward without the dietitian) to compare against, so we can’t be completely certain the dietitian caused all the improvements. Some improvements might have happened anyway due to increased attention to the problem.

The Bottom Line

If you’re an older adult facing hip fracture surgery or hospitalization: (1) Ask your hospital if they have a nutrition specialist and request a consultation (Confidence: High). (2) Keep track of what you’re eating and ask staff if you’re meeting your nutrition goals (Confidence: High). (3) Work with your care team to set specific nutrition targets based on your needs (Confidence: Moderate). If you’re a hospital administrator: Consider assigning a nutrition specialist to work with orthopedic wards, as this appears to improve patient outcomes (Confidence: Moderate, based on one hospital’s experience).

This research is most relevant for: older adults with hip fractures or other serious injuries, their families and caregivers, hospital staff working in orthopedic or trauma units, and hospital administrators looking to improve patient outcomes. It’s less relevant for younger, healthier people without fractures, though the general principle that better nutrition care helps recovery applies broadly.

In this study, improvements happened within four months. However, the most important timeline is individual healing: adequate nutrition typically helps fracture healing within weeks to months, but full recovery from a hip fracture usually takes 3-6 months or longer. You should see improvements in energy and healing within 2-4 weeks of getting adequate nutrition, but patience is important for complete recovery.

Want to Apply This Research?

  • Track daily protein intake (in grams) and total calories consumed. Set a goal based on your doctor’s recommendation (often 1.2-1.5 grams of protein per kilogram of body weight for fracture healing) and log meals daily. This creates accountability and helps identify gaps.
  • Use the app to set meal reminders at consistent times (breakfast, lunch, dinner, snacks). Include high-protein foods like eggs, yogurt, chicken, fish, beans, or nuts. When you log meals, note how you’re feeling and any barriers to eating (nausea, difficulty chewing, etc.) so you can discuss solutions with your care team.
  • Weekly review: Check if you’re hitting 80% of your nutrition goals. Monthly check-in: Share your nutrition logs with your doctor or dietitian to adjust goals if needed. Track energy levels and healing progress alongside nutrition data to see the connection between eating well and feeling better.

This study describes improvements at one hospital and should not be considered medical advice. Hip fracture recovery is complex and requires individualized care from your medical team. Nutrition needs vary based on age, weight, kidney function, and other health conditions. Before making changes to your diet or nutrition plan, consult with your doctor, registered dietitian, or healthcare provider. This research suggests that better nutrition care may help, but it does not replace professional medical evaluation and treatment. If you have concerns about your nutrition or recovery, contact your healthcare provider immediately.