A successful way for performing nutritional nursing assessment in older patients

Abstract

The aim of this study was to obtain increased knowledge and understanding about what can be promoting and facilitating for nurses to perform nutritional nursing assessment in older patients. The frequency of older patients at nutritional risk or suffering from undernutrition is high in hospitals. Studies have shown frequent lack of awareness about signs of undernutrition as all patients are, for example, not weighed. Nurses' descriptions about nutritional problems have also been found to be often vague and unspecific. A qualitative design was used. Ten conveniently chosen registered nurses, working with older patients in two hospitals in western Sweden were interviewed. Four of the interviews were performed during 2003 and six during 2006. The interviews were analysed according to a Gadamerian-based hermeneutic research method. The analyses revealed that promoting aspects for performing nutritional nursing assessment in older patients were to get information by dialogues, by observations and controls, by collaboration with other caregivers and professionals and by performing continuous follow-ups. Necessary conditions, beside knowledge and consciousness about nutritional issues, were to have interest, give time to listen to the patient's story and furthermore, be sensitive to the patient's wishes, be able to assess the patient's motivation to eat and have an ethical awareness. A successful way that promoted the performance of nutritional nursing assessment in older patients was to use different approaches as interactive dialogues, observations, controls and collaboration in team. Such a nutritional nursing assessment was an ongoing process during the patient's hospital stay. These results highlight that nurses have an important role in identifying eating problems in older patients, which has to be a prioritized issue in the care of older people.