| dc.description.abstract | Background: The prevalence of malnutrition in hospitals is high, and malnutrition is associated with poor clinical outcomes. Nurses have an important role in the identification, prevention, and treatment of malnutrition. Nutritional care is one of the fundamental topics of nursing care research in the project Basic Care Revisited. One of the first steps to improve the quality of care, is to have insight in the current practice of nutritional care and the barriers and facilitators nurses experience.
Objective: To describe the current practice of nutritional care for geriatric patients in hospitals and the facilitators and barriers nurses experience.
Method: An ethnographic design with observations and focus group interviews with healthcare professionals in a hospital.
Analysis: The data were examined using a thematic analysis. The observation data were coded using the six steps of the nutrition process. The results of the observations were used to make a topic list for the focus group interviews. The focus group interviews were coded using open and axial coding.
Results: 130 hours of observation were performed, and 13 professionals participated in two focus group interviews. Nurses perform various nutritional interventions. The monitoring of interventions and outcome management is no commonly executed. Identification, high workload, frequent changes in staff, electronic patient record, insight in nutrition intake, multidisciplinary cooperation and priority to nutritional care are barriers. Electronic patient record and environment during mealtimes were facilitators.
Conclusion: The observations showed that the current practice of nutritional care is mostly focused on interventions, with less emphasis on monitoring and outcome management of nutritional interventions. Seven barriers and two facilitators were identified.
Implication of key findings: The results of the study demonstrate the need for explicit attention to monitoring and evaluation in the development of an evidence-based nutritional intervention. | |
