Factors Influencing the Delivery of Nutritional Care by Nurses for Hospitalised Medical Patients with Malnutrition; A Qualitative Study
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Keywords
hospital, malnutrition, fundamentals of care, nursing nutritional care, qualitative study, patient participation
Abstract
The purpose of this study is to provide a comprehensive understanding of how nursing nutritional care is provided in hospitals. This will be achieved by examining the nursing care practices and investigating the attitudes and experiences of healthcare professionals from other disciplines on patient involvement in nutritional care.
Background: The incidence of malnutrition among hospitalized patients remains elevated. The crucial contribution of nurses in recognizing and managing malnutrition is a vital component of the fundamental principles of healthcare. Nurses have a crucial role in delivering the highest quality of nutritional treatment within the hospital setting. To effectively combat malnutrition, it is necessary to employ a systematic nursing approach and involve patients in an active role.
Design: A multicentre qualitative investigation employing ethnographic observations and focus groups
Methods: An investigation was carried out to directly monitor the provision of nutritional care in two nursing wards. The nurses and inpatients were closely observed, and the collected data was analyzed thematically using the principles of care framework. Following that, a total of six focus groups were conducted on three nursing wards, involving nurses, dietitians, and nutrition assistants (n = 34). The data underwent analysis utilizing open, axial, and selective coding techniques. The study was reported using the COREQ guidelines.
Results: Over a period of 54 days, which is approximately 183 h, a total of 39 nurses were monitored in two medical wards. By observing nurses and patients, three actions in nutritional care delivery were identified: (1) screening and evaluation to determine if patients are at risk, (2) creating nutritional care plans, and (3) monitoring and evaluating outcomes while planning for the transition of care. Furthermore, the focus groups highlighted obstacles, enablers, requirements, and anticipated outcomes for the most effective delivery of nursing nutritional care.
Conclusion: The current research offers insights into the challenges associated with providing nursing nutritional care. There is a scarcity of patient involvement in the nutritional treatment process. Effective solutions based on empirical evidence are necessary to enhance the knowledge and abilities of nurses and patients in order to actively engage in the management of (mal)nutrition.
Relevance: The results of this investigation are utilized to create a nursing nutrition intervention aimed at maximizing patient involvement in the management of malnutrition.
Patient or public involvement: Throughout the investigation, individuals did not participate in the observations of care or interviews. The researchers monitored the administration of nutritional care in medical wards as passive participants. Nurses, nutrition assistants, and dietitians were solicited for feedback on the transcripts of the interviews during the focus groups.
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