Abstract
To examine reliability of the screening data collected by nursing students. Furthermore, to examine students' evaluations of participation in nutritional screening of older hospitalised patients. In cross-sectional study on nutritional risk and care in older hospitalised patients, the prevalence for undernutrition was 45%, a finding corresponding with other international studies. In this study, nursing students (n=173) screened older patients (n=508) for malnutrition, while they were in hospital practice. The validity of the results thus depends on the quality of the students screening. Agreement in measurements on age, weight, height and nutritional risk scoring by students using Nutritional Risk Screening (NRS 2002) was assessed for 30 randomly selected hospitalised patients (≥70years), with data collected by students in the study and two additional students. Bland-Altman analysis was used for continuous measurements, while kappa statistic was used to assess agreement between the NRS 2002 scores. Experiences of all included students were described. A STROBE checklist was completed. No significant bias was found among the students. Questionnaire data showed that 70.5% of the students agreed that the NRS 2002 was easy to use and 59.0% found it easier to measure the patients' height than weight. It was 70.5% who found it difficult to find previously recorded information on the patients' weight in the electronic records. Only 13% found it easy to find information on patients' nutritional status. 37.0% agreed that participating in the screening was instructive, and 34.0% gained increased interest in nutritional care. Collaborating with students in screening older patients for nutritional risk and undernutrition gave reliable data and increased the students' interest in nutritional care among hospitalised patients. Collaborating with students contributes with valuable data for practice and research. Moreover, it increases students' engagement for improved care practices for older patients.
Highlights
Older patients are at risk of malnutrition, and many are already undernourished on admission to hospital (Cederholm et al, 2015; Fávaro-Moreira et al, 2016; Ray, Laur, & Golubic, 2014; Rojer et al, 2016)
As part of a large-scale interdisciplinary clinical research project entitled ‘Nutritional status and care of older patients', 173s-year nursing students performed nutritional screening on 508 patients (48.8% women) aged over 70 as part of a coursework requirement during their hospital practice placement
Our study showed that recommended nutritional care practice in compliance with national and international guidelines was not implemented in clinical hospital practice
Summary
Older patients are at risk of malnutrition, and many are already undernourished on admission to hospital (Cederholm et al, 2015; Fávaro-Moreira et al, 2016; Ray, Laur, & Golubic, 2014; Rojer et al, 2016). Nutrition is a basic nursing care, and nurses play a key role in monitoring patients' nutritional needs and identifying patients who are undernourished or who are at risk of malnutrition (Cate et al, 2019; Volkert, Beck, Cederholm, Cruz-Jentoft, et al, 2019). Faster implementation of practice in new methods, guidelines and quality indicators can be achieved by familiarising students with them as part of their clinical training. In this way, they can increasingly integrate evidence-based practice into their daily work and thereby better safeguard patients' basic nutritional needs. To gain an understanding of evidence-based practice in their future nursing role, it is important that nursing students participate in clinical research projects (Muraraneza, Mtshali, & Bvumbwe, 2020; Ramsay, Wicking, & Yates, 2020)
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