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04 | Preparation and Delivery of Between-Meal Snacks and Supplements


Nearly all healthcare facilities offer snacks to clients. However, not all snacks are supplements. A snack may be a simple cookie offered midmorning or a granola bar in the afternoon.


Snacks may be part of the daily routine or may be scheduled only for clients with specified dietary needs, such as a diet order for six small feedings each day or a snack coordinated with insulin injection for a client with diabetes. An evening snack is generally standard for senior living residents and most clients with diabetes.


Moreover, it is important to understand that not all supplements are commercially made or come in a carton. Many of the items available today are ‘nutritionally enhanced’ food items, not pharmaceutically produced supplements. Some commonly used items include:


• A packet of commercial instant breakfast powder and 8 ounces of milk


• Individual cartons of frozen enriched milkshakes • High protein power drinks


Glossary Medication


Administration Record (MAR)


A documentation system that tracks each dose of medications or supplements given to a client in a healthcare setting


eMAR Electronic version of Medication Administration Records


Snacks and nourishments must comply with the diet order and may be pre-assembled by an assigned staff member or team. These may be delivered as a group to each nursing station for distribution by nursing staff or delivered directly to clients’ rooms by dining services staff. In some settings the supplements are included on the Medication Administration Record (MAR) or eMAR for electronic versions which require the nursing staff to verify consumption of the item.


While prescribed supplements are prepared and delivered to specific clients, between-meal and evening snacks are often provided through nursing unit pantries from which nursing staff withdraw items requested by clients. In some locations, dining services employees travel from room to room with a rolling cart and offer diet-appropriate snacks.


Both options allow clients to choose what they want at the time of service and receive personal attention to their requests. In many cases they improve turnaround time for processing requests and may also streamline labor requirements. Dining services and nursing staff providing snacks on demand must be familiar with dietary restrictions and must assure that foods offered meet the diet order.


The supplement delivery system should allow for snacks and supplements to be given between meals, not with meals unless the supplement is part of a fortified liquid diet. This method helps encourage consumption of whole foods versus supplements. Staff should be mindful to ensure that the nutrition supplement or snack does not become a meal replacement. Consider the following scenario:


Foodservice Management—By Design


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