Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Elise Schaller, DNP, MHA, APRN, CPNP-PC


Elise Schaller, DNP, MHA, APRN, CPNP-PC

Cathy Koetting, DNP, APRN, CPNP, PMHS, FNP-C

Andrea Horbey, D.O., FCAAP, FACOP


Problem: Over 1/3 of children in the United States are overweight or obese and children’s nutritional status while hospitalized worsens rather than improves. Hospital meals have too many calories, too much sugar, and too few nutrients compared to recommended guidelines for children. The primary purpose of this quality improvement project is to increase the amount of healthy foods ordered by children in a southeastern pediatric hospital unit through implementation of a menu guide.

Methods: A quality improvement pre-post interventional pilot study was done through implementation of a child friendly menu guide promoting healthful eating. Data was collected by retrospective and prospective review of food orders over a two-month time period on a pediatric inpatient unit in a Southeastern Florida hospital.

Results: There was a statistically significant decrease in the amount of low health foods ordered in the post-implementation phase when compared to the pre-implementation phase (alpha value of 0.05, p = 0.049). Although there was not a statistically significant difference in high health and medium health orders, the means of each of these categories increased in the post-implementation phase. There was a 28% increase in healthy foods ordered and a 74% decrease in unhealthy foods ordered.

Implications for practice: Child friendly menu guides promoting healthy food options through menu labeling techniques have a positive impact on meal selections in a pediatric hospital unit. Utilizing menu guides can increase healthy foods ordered and decrease unhealthy foods ordered. Permanent use of menu guides that promote healthful eating are recommended in hospital settings.

Additional Files


menu guide front .png (1917 kB)
menu guide front

menu guide back.png (1949 kB)
menu guide back