Implementing nutritional guidelines – the effect of systematic training for nurse nutrition practitioners

Abstract

Approximately 40% of patients admitted to hospitals are undernourished. Implementing nutritional guidelines might reduce the incidence of malnutrition, and it requires education and training for the hospital staff. It was hypothesised that a training programme focusing on the staff behaviour would increase the identification of eating difficulties, improve patients' knowledge about appropriate food choices and increase the number of snacks eaten between meals and thereby to reduce the risk of undernutrition. A pre- and post-test design was used to evaluate the effect of the training programme for nurses. The training was conducted in five modules over 1 year and combined nutritional issues with issues on implementation and theories of planned change. The programme was based on experimental learning theories and the steps of look, think and act. The effect on the patients was measured by a patient questionnaire. After implementing the guidelines, more patients discussed their eating difficulties with the staff, received relevant assistance during the meal and were served the type of food they had ordered and could chew. The patients' knowledge of appropriate food choices from the menu increased, suggesting that the nutritional intake of the patients had improved. Our findings suggest that a strategy based on the principles of experimental learning theory and the phases in the look, think and act model facilitated the implementation of nutritional guidelines in a hospital setting.