Quality Of Nutritional Care Research Articles

Quality of nutritional status assessment and its relationship with the effect of rainfall on childhood stunting: a cross-sectional study in rural Burkina Faso

ObjectivesIn Burkina Faso, one in every four children under 5 years is stunted. Climate change will exacerbate childhood stunting. Strengthening the health system, particularly the quality of nutrition care at primary health facilities, can minimise the adverse climate effect on stunting. Thus, we examined the quality of nutritional status assessment (QoNA) during curative childcare services in primary health facilities in rural Burkina Faso and its relationship with rainfall-induced childhood stunting. Study designWe conducted a cross-sectional analysis using anthropometric, rainfall, and clinical observation data. MethodsOur dependent variable was the height-for-age z-score (HAZ) of children under 2 years. Our focal climatic measure was mean rainfall deviation (MRD), calculated as the mean of the difference between 30-year monthly household-level rainfall means and the corresponding months for each child from conception to data collection. QoNA was based on the weight, height, general paleness and oedema assessment. We used a mixed-effect multilevel model and analysed heterogeneity by sex and socio-economic status. ResultsAmong 5027 young (3–23 months) children (mean age 12 ± 6 months), 21% were stunted (HAZ ≤ −2). The mean MRD was 11 ± 4 mm, and the mean QoNA was 2.86 ± 0.99. The proportion of children in low, medium, and high QoNA areas was 10%, 54%, and 36%, respectively. HAZ showed a negative correlation with MRD. Higher QoNA lowered the negative effect of MRD on HAZ (β = 0.017, P = 0.003, confidence interval = [0.006, 0.029]). Males and children from poor households benefited less from the moderating effect of QoNA. ConclusionImproving the quality of nutrition assessments can supplement existing efforts to reduce the adverse effects of climate change on children's nutritional well-being.

Implementation of nutritional care in hospitals: A qualitative study of barriers and facilitators using implementation theory.

Disease-related malnutrition is prevalent among hospitalised patients, but not all patients achieve the needed nutritional care. At a Danish University Hospital, focus has been on implementing nutritional practices based on clinical guidelines, but there is continuously variation between the wards regarding the quality of nutritional care. The aim of this study was to identify the potential barriers and facilitators for implementation of the clinical guidelines for nutritional practices and to recommend suggestions for development of nutritional practices, using a theoretical implementation strategy. The design was a qualitative interview study of employees at a Danish University Hospital, using a semi-structured interview guide. The participants were nurses, nurse's assistant, nurse nutrition expert, head nurse and dieticians. We recruited 11 employees, representing eight different wards. The analysis identified six themes: (1) clear allocation of responsibilities and committed management enhances nutrition practices, (2) leadership support is essential, (3) physical settings and tools affect possibilities for action, (4) selection of equivalent staff is core, (5) teaching promotes the knowledge and skills and (6) a dietitian in the ward facilitates implementation of nutritional care. Barriers and facilitators among the themes were identified and has led to suggestions to strengthen nutritional care, based on implementation theory. Various factors were identified as having impact on the implementation of nutrition practices and different suggestions have emerged to accommodate those factors, as well as to apply an implementation strategy to facilitate change in practice.

Low quality of maternal and child nutritional care at the primary care in Mexico: an urgent call to action for policymakers and stakeholders

BackgroundMaternal and child malnutrition represents a public health problem in Mexico Primary care (PC) is responsible for introducing women and children under five to the health system, detecting diseases on time, and providing medical services, including pharmacological treatment if necessary. Providing these services with quality is essential to improve maternal and child health. This study evaluated the quality of nutritional care during preconception, pregnancy, postpartum, infancy, and preschool age at the PC health units across six Mexican states between 2020 and 2021.MethodsWe conducted a cross-sectional study with a mixed approach in units of the Secretary of Health to assess the quality of nutritional care during preconception, pregnancy, postpartum, childhood, and preschool age. The level of quality was calculated by the percentage of compliance with 16 indicators that integrated a Quality Index of Maternal and Child Nutritional Care (ICANMI, by its Spanish acronym). Compliance by indicator, by life stage, and overall was categorized using the following cut-off points: poor quality (≤ 70%), insufficient quality (71-89%), and good quality (≥ 90%). The perceptions of the barriers and facilitators that affect maternal and child nutrition were evaluated through semi-structured interviews with health professionals (HP) and users. All qualitative instruments were developed with a gender and intercultural perspective.ResultsConsidering the whole sample studied, maternal and child nutritional care quality during the five life stages evaluated was bad (compliance: ≤12%), reflected in the ICANMI, which had a compliance of 8.3%. Principal barriers identified to providing high-quality nutritional care were the lack of knowledge and training of health professionals, shortages of equipment, medicine, personnel, and materials, the disappearance of the social cash transfer program Prospera, the absence of local indigenous language translators to support communication between doctor and patient, and the persistence of machismo and other practices of control over women.ConclusionsThese findings underscore the need for initiatives to improve the quality of nutritional care in PC facilities across Chihuahua, State of Mexico, Veracruz, Oaxaca, Chiapas, and Yucatan. It is necessary for government and health authorities, along with various stakeholders, to collaboratively devise, implement, and assess intercultural and gender-oriented policies and programs geared towards ensuring the health infrastructure and enhancing the training of health professionals to diagnose and treat the prevalence and occurrence of diverse forms of malnutrition in both maternal and child populations.

Nursing interventions in neonatal feeding

This research focuses on neonatal feeding, recognizing the relevance of nursing professionals in this context to ensure adequate and timely nutritional support for these small patients. The research problem addressed focuses on the need for a thorough understanding of optimal feeding practices in neonatology, modalities such as enteral, parenteral and breastfeeding are considered. Physiological immaturity and susceptibility to various disorders mean that neonates face specific feeding challenges. The main objective is to perform a comprehensive systematic review of the available scientific literature in order to analyze and synthesize the current evidence. Based on the above, the aim is to provide guidance and evidence-based recommendations to improve the quality of nutritional care provided to neonates. The methodology used is qualitative, applying the PICO model to structure the research question. An exhaustive search was carried out in key electronic databases, using relevant terms and descriptors. The main results reveal the importance of personalized nursing care, adapted to the individual needs of each neonate. Breastfeeding is highlighted as a fundamental option, but the relevance of other modalities to address various clinical situations is recognized.

Protecting optimal childhood growth: systematic nutritional screening, assessment, and intervention for children at risk of malnutrition in the Kingdom of Saudi Arabia.

In 2024, the Kingdom of Saudi Arabia Advisory Board on Pediatric Nutrition (KSA-ABPN) reviewed childhood undernutrition in the Middle East. We sought to foster efficient nutritional care for infants and children at nutritional risk. Severe malnutrition due to starvation is rare in Saudi Arabia, so we focused on early recognition and treatment of children with mild growth impairment that forewarns risk for further nutritional decline. This paper summarizes our findings and introduces a recommended guide for nutritional screening, assessment, and follow-up interventions. The KSA-ABPN aimed to build an algorithm with pathways and tools to facilitate up-to-date nutrition-care practices for infants and children. The algorithm is intended to encourage consistent professional training-for and use-of validated tools, adoption of standardized thresholds for intervention, and delivery of nutritional support. Consistent care will increase opportunities for comparative analyses of various treatment strategies and their health and cost outcomes. We developed a 4-stage algorithm for identifying and caring for children at nutritional risk: (i) screening for clinical risk factors and age-related growth measures, (ii) observation of malnutrition-related physical signs, diet history, and/or laboratory detection of evidence indicating specific nutrient deficiencies, (iii) assessment of the severity of nutritional deficit, and (iv) development of a patient-specific Nutrition Care Plan that includes diet counseling, supplementation, routine monitoring, and follow-up. By helping professionals identify nutritional risk and specific nutritional deficits in infants and children early in the clinical course, we seek to expand quality nutritional care and ensure that children grow and develop fully.

Self-Perceived Competency Assessment among Dietetics Students in Universiti Sultan Zainal Abidin (UniSZA)

This study aimed to assess the self-perceived competency among dietetics students in Universiti Sultan Zainal Abidin (UniSZA). The self-perceived competency of the students was evaluated using the Nutrition Competence (NUTCOMP) questionnaire, a validated tool designed to measure the self-perceived competence of healthcare professionals, including dietitians, in providing nutrition care to patients with chronic diseases. A total of 54 dietetics students from UniSZA participated in the study, all enrolled in Year 4 Semester 2 during their clinical training. They completed the NUTCOMP questionnaire, which consists of various domains and items related to nutrition care practice, including communication skills, critical thinking, evidence-based practice, and professionalism. The results showed that the students perceived themselves to have a high level of competency, with a mean score of 140.1 and a standard deviation of 26.83. Specifically, the students reported high levels of confidence in their ability to interact with clients and stakeholders, interpret nutritional information into lay language, and apply critical thinking skills to research and evaluate nutrition practices. The findings indicate that the students felt well-prepared to enter the field of dietetics upon graduation, reflecting a positive perception of their competence in nutrition care. However, it is essential to acknowledge that self-perceived competency may not always align with actual performance, and objective assessments are needed to validate these self-perceptions. In conclusion, the findings of this study contribute valuable insights into the self-perceived competency of dietetics students in UniSZA. The results suggest that the students have confidence in their knowledge and skills related to nutrition care, indicating a positive outlook on their future roles as dietitians. Further research could explore the relationship between self-perceived competency and actual performance in dietetics practice, as well as investigate the factors influencing the development of competency among dietetics students. Understanding and enhancing competency among future dietitians are crucial for improving the quality of nutrition care and ultimately promoting better health outcomes for patients.

Accreditation of nutrition support teams: A new initiative by the Turkish Society of Clinical Enteral & Parenteral Nutrition

ObjectivesAccreditation is a process to evaluate compliance of an institution or organization with predetermined performance standards, focusing on achieving continuous improvement strategies and optimal quality standards and motivating the accredited organization to do so. There is no established accreditation program for nutrition support teams (NSTs) at national and international levels. In order to increase the standards of NSTs, developing an accreditation program is being planned by the Turkish Society of Clinical Enteral & Parenteral Nutrition (KEPAN). MethodsAccreditation standards were developed by a study group under the organization of KEPAN. Minimum standards for composition, qualifications, physical requirements, workflow charts, medical records, and both patient and health care providers’ safety measures in NSTs were specified. These standards were uploaded to a computer program, and the necessary infrastructure for a web-based management of accreditation processes was developed. ResultsAn organization applying for accreditation should fill in the application form on KEPAN website electronically. Eligibility criteria for accreditation include number of NST members, physical environment, patient monitoring requirements, research, and training. A total of 22 standards are surveyed under 13 sections. These standards contain 61 criteria. To be accredited, each of 22 standards must score >70 and each of 13 sections must score >80. ConclusionsIn order to increase the quality of nutritional care and improve patient outcomes, an accreditation program has been developed. This program principally sets the basic standards, organizational scheme, and responsibilities of NSTs.

Association between Malnutrition Assessed by the Global Leadership Initiative on Malnutrition Criteria and Mortality in Older People: A Scoping Review

The Global Leadership Initiative on Malnutrition (GLIM) criteria were introduced in 2018 for the diagnosis of malnutrition in adults. This review was aimed at gathering the evidence about the association between malnutrition according to the GLIM criteria and mortality in older people, an emerging and clinically meaningful topic in the implementation of the GLIM criteria in geriatric healthcare settings. This scoping review considered meta-analyses, systematic reviews, cohort studies, and cross-sectional studies published in PubMed, Scopus, and the Cochrane Database for Systematic Reviews from the development of the GLIM criteria in 2018 to January 2023. Seventeen articles (15 cohort and 2 cross-sectional studies) were included. The association between GLIM criteria and mortality had been assessed in hospitalized (11 over the 17 articles) and community-dwelling older populations, and those in nursing homes. The review found a strong association between malnutrition according to GLIM criteria and mortality in hospitalized (1.2-fold to 7-fold higher mortality) and community-dwelling older people (1.6-fold to 4-fold higher mortality). These findings highlight the prognostic value of the GLIM criteria and support strategies towards the implementation of malnutrition evaluation according to the GLIM, in order to optimize comprehensive geriatric assessment and provide older people with the highest quality of nutritional care. Studies in nursing home populations were very scarce and may be urgently required.

Healthcare providers’ knowledge, attitude, and practice on quality of nutrition care in hospitals from a developing country: a multicenter experience

BackgroundDespite the fact that malnutrition can affect both recovery and outcome in acute care patients, little is known about malnutrition in Palestine, and even less is known about the assessment of malnutrition knowledge, attitudes, and practices (M-KAP) toward healthcare providers and nutrition care quality measures in hospitalized patients. Therefore, this study aimed to evaluate the M-KAP of physicians and nurses in routine clinical care and determine the influencing factors.MethodsFrom April 1 to June 31, 2019, cross-sectional research was performed at governmental (n = 5) and non-governmental (n = 4) hospitals in the North West Bank of Palestine. Data were collected using a structured self-administered questionnaire from physicians and nurses to collect information on knowledge, attitude, and practices related to malnutrition and nutrition care, alongside sociodemographic characteristics.ResultsA total of 405 physicians and nurses were participated in the study. Only 56% of participants strongly agreed that nutrition was important, only 27% strongly agreed that there should be nutrition screening, only 25% felt food helped with recovery, and around 12% felt nutrition as part of their job. Approximately 70% of participants said they should refer to a dietitian, but only 23% knew how and only 13% knew when. The median knowledge/attitude score was 71, with an IQR ranging from 65.00 to 75.00, and the median practice score was 15.00 with an IQR of 13.00–18.00. The mean knowledge attitude practice score was 85.62 out of 128 with SD (9.50). Respondents who worked in non-governmental hospitals showed higher practice scores (p < 0.05), while staff nurses and ICU workers showed the highest practice score (p < 0.001). Respondents with younger age categories, working in non-governmental hospitals in the ICU as practical and staff nurses, showed the highest KAP score (p < 0.05). Significance positive correlations were found between respondents’ knowledge/attitude and practice scores regarding the quality of nutrition care in hospitals (r = 0.384, p value < 0.05). In addition, the result also revealed that almost half of respondents believed that the most important barriers to inadequate intake of food at the bedside are related to food appearance, taste, and aroma of meals served (58.0%).ConclusionsThe research revealed that inadequate knowledge was perceived as a barrier to effective nutrition care to the patient. Many beliefs and attitudes do not always translate into practice. Although the M-KAP of physicians and nurses is lower than in some other countries/studies, it highlights a strong need for more nutrition professionals in the hospital and increasing nutrition education to improve nutrition care in hospitals in Palestine. Furthermore, establishing a nutrition task force in hospitals elaborated by dietitians as the unique nutrition care provider will assure to implementation of a standardized nutrition care process.

Assessment of the quality of inpatient meals and nutrition and dietetics service processes in select Philippine public hospitals.

The nutrition and dietetics service in Philippine public hospitals was implemented by the Department of Health in 2016 to standardise the daily allowance and nutritional content of inpatient meals. Five years later, it is timely for the Department of Health to assess the quality of inpatient meals and mandated nutrition processes in areas such as staffing, food service, and outcomes monitoring. A mixed-method sequential explanatory design was employed using (1) quantitative assessment through a facility survey (n=193 hospitals) and (2) qualitative exploration of quantitative results through 6 focus group discussions (n=36 hospitals). Philippine public hospitals were unequipped with the inputs necessary to implement processes that produce high-quality meals for patients. The hospitals were unable to comply with the required minimum meal allowance (51%), nutritional content of meals (40%), and food service standards. Moreover, they had insufficient human resources and inefficient food procurement practices. The quality of nutrition care and inpatient meals in Philippine public hospitals, who serve mostly people on low incomes, is a neglected problem in the Philippines. Moving forward, a systems approach involving the Department of Health, its regional offices, and hospital management is necessary to equip Philippine public hospitals with the inputs and structures necessary to provide high-quality nutrition care and inpatient meals that will facilitate patient recovery and overall patient health.

Good nutrition across the lifespan is foundational for healthy aging and sustainable development.

Ensuring healthy lives and promoting wellbeing across the age spectrum are essential to sustainable development. Nutrition is at the heart of the World Health Organization (WHO) Sustainable Development Goals, particularly for Sustainable Development Goal 2/Subgoal 2, which is to End all forms of malnutrition by 2030. This subgoal addresses people of all ages, including targeted groups like young children and older adults. In recent decades, there have been marked advances in the tools and methods used to screen for risk of malnutrition and to conduct nutritional assessments. There have also been innovations in nutritional interventions and outcome measures related to malnutrition. What has been less common is research on how nutritional interventions can impact healthy aging. Our Perspective article thus takes a life-course approach to consider what is needed to address risk of malnutrition and why, and to examine how good nutrition across the lifespan can contribute to healthy aging. We discuss broad-ranging yet interdependent ways to improve nutritional status worldwide-development of nutritional programs and policies, incorporation of the best nutrition-care tools and methods into practice, provision of professional training for quality nutritional care, and monitoring health and economic benefits of such changes. Taken together, our Perspective aims to (i) identify current challenges to meeting these ideals of nutritional care, and to (ii) discover enabling strategies for the improvement of nutrition care across the lifespan. In harmony with the WHO goal of sustainable development, we underscore roles of nutrition to foster healthy human development and healthy aging worldwide.

Development and validation of a new set of indicators to assess the quality of maternal and child nutritional care at the primary care.

Maternal and child malnutrition is a worldwide public health problem with short, medium, and long-term adverse consequences for both mother and child. In Mexico, maternal and child malnutrition represents a serious public health problem that must be urgently addressed. In this context, Primary Health Care (PHC) plays an important role in the prevention, detection, monitoring, and treatment of the different forms of maternal and child malnutrition. Assessing the quality of nutritional care offered at this level of care is necessary in order to improve it; however, there are no indicators for the evaluation of this quality. Therefore, this study aimed at developing a set of indicators to assess the quality of maternal and child nutritional care at PHC. We developed indicators for different stages of life: preconception, pregnancy, infancy, and preschool age. A systematic review of the literature on clinical guidelines for the prevention, diagnosis, and treatment of the different forms of malnutrition was carried out; the recommendations of the guidelines evaluated with good quality were extracted. Based on these recommendations, 22 indicators were constructed. A pilot study was carried out to validate the indicators and 16 indicators were selected to assess the maternal and child nutritional care at PHC.

Dietitians Working in Continuing Care Facilities in Nova Scotia: Pre- and Post-COVID-19 First Wave.

Continuing care (CC) facilities have been impacted by a growing demand for services, insufficient resources for the provision of quality food and nutrition care, and, most recently, the COVID-19 pandemic. This study explored the roles and responsibilities of dietitians working in CC facilities in Nova Scotia (NS) before and after the COVID-19 first wave. Using ethics-approved questionnaires, the estimated 75 dietitians working in CC facilities in NS were surveyed in Fall 2019 and Fall 2020 about their roles and responsibilities. Twenty responded to the first questionnaire and 15 to the second. Analysis of data included simple statistical and qualitative description methods. The findings highlighted the complexities and challenges faced by these dietitians in the provision of resident nutrition care, overseeing foodservices, training staff and dietetic interns, and contributing to facility specific care committees before and after the COVID-19 first wave. There is a need to advocate for minimum standards for dietetic and foodservice funding in CC facilities based on higher acuity and complex care needs of residents and considering the multifaceted roles of dietitians in CC. Efforts to improve awareness about the roles of dietitians working in CC among resident families, other dietitians, and dietetic interns are also needed.

Developing the Quality in Nutrition Care Model for Dietitians (QUINCE-MOD) in primary care: A mixed-method survey of healthcare consumers and professionals.

Evidence-based models are effective tools for informing quality improvement activities in health care. The Quality in Nutrition Care (QUINCE) model is an evidence-based model that describes quality nutrition care in the primary care setting but has not been applied to primary care dietetics. The present study comprised two phases. In the first phase, the study aimed to evaluate and compare healthcare consumers and professional perspectives on the importance of the 10 statements to understand their relevance for dietetics care. In the second phase, the study aimed to test and enhance the QUINCE model using healthcare consumer and professional responses to statements that were identified as relevant to primary care dietetics in the first phase. Quantitative and qualitative data were collected using an online survey comprising statements describing quality dietetic care adapted from the complexity literature. Quantitative data were analysed using descriptive statistical analysis to investigate statement importance as rated by participants using a six-point Likert scale. Qualitative content analysis was performed on the qualitative data using a deductive-inductive approach to identify patterns in the data. The QUINCE model was compared with identified patterns and modified as appropriate. One hundred and fourteen consumers and 107 primary care professionals agreed on the importance of seven statements but expressed divergent views on the remaining three statements that addressed: (1) access to medical records; (2) access to performance and safety information; and (3) variation in care between dietitians. The QUINCE model was modified to produce the Quality in Nutrition Care Model for Dietitians (QUINCE-MOD) describing quality dietetic care in the primary care setting. Consumers and professionals share views on some aspects of quality dietetic care but diverge on other aspects. The QUINCE-MOD is an evidence-based, complexity-informed model that describes components of quality relevant to primary care dietetics. The model should be applied at the practice level to reflect the unique perspective of quality at that level.

Sources of Human’s Aggression, Violence, Antisocial and Addictive Behaviors

In the 21st century hunger, starvation and malnutrition is still a scourge of mankind. According to World Bank reports a rise of millions of people lacked year-round access to adequate food in 2020 compared to 2019. Malnutrition, poverty, lack of quality education and insufficient health care are causes and consequences of each other. Preconceptual, prenatal and early postnatal malnutrition have life-long negative consequences on human’s health and behavior via epigenetic processes that regulate gene expression providing short-term survival benefits but predispose to various pathological conditions in adulthood. Based on scientific research there is not any doubt that early epigenetic changes play a major role in the development of excessive aggression, violence, antisocial and addictive behaviors. A body of evidence shows that clinical pictures like oppositional defiant disorders (ODD), conduct disorders (CD) and antisocial personality disorders (APD) have a neurodevelopmental origin based on epigenetic changes of gene expression. It is suggested that only early intensive therapeutic interventions focusing on autonomy, sense of competence and social connectedness in an individualistic, systemic and tightly structured positive and safe environment including healthy lifestyle and nutrition could prevent the progression of ODD into CD and eventually into APD. Quality nutrition, quality education and adequate health care for every human, starting at the very first days of life, are claimed to be unconditional premises to transform humanity into a peaceful species able to deal with the future challenges and dangers of life on planet earth.

Opportunities and Lessons Learned to Support Didactic Experiential Learning through a Nutrition Education and Counseling Pilot at a Federally Qualified Health Center

Supervised student care in safety-net clinics affords multiple benefits. These benefits include the expansion of students skills, empathy, and interprofessional education (IPE) opportunities, maintenance of clinical skills for faculty, and work to address gaps in care for low-income, underinsured, or uninsured patient groups.1-7 Historically, many safety-net clinics have been managed by medical students, who have reported barriers to providing nutrition education and counseling to patients.8 Integration of supervised Didactic Program in Dietetics (DPD) students into these under-resourced clinical settings ensures access to quality nutrition care for patients and expands training opportunities for DPD students.

Quality of Nutritional Care Assessment among Critically-ill Patients in a Tertiary Government Hospital

Background and Objectives. Malnutrition is prevalent both at baseline admission and because of hospitalization. It is aggravated by adverse hospital practices and results in poor outcomes, reduced quality of life, and higher treatment costs. Improving quality of care involves nutritional intervention as a low-risk, cost-effective strategy which guides providers in improving practices systems-wise. This study aims to assess the quality of nutritional care and the nutritional status of critically- ill patients admitted in a low-resource setting.&#x0D; Materials and Methods. This is a mixed methods study among adults admitted in intensive care units (ICUs) of a tertiary government hospital. Anthropometric and biochemical indicators were obtained through chart review. The degree of malnutrition was assessed using the Subjective Global Assessment. Quality indicators under Donabedian domains were assessed and compared to current standards. The length of ICU stay and mortality rate were recorded. Dietary prescription and provision practices of healthcare providers were supplemented by a focus group discussion (FGD). Factors causing provision interruptions were also identified.&#x0D; Results and Discussion. Sixty-four ICU admissions were included. Staff-to-patient ratio was not ideal. Under process-related factors, out of 49% with actual anthropometric documentations (rest were estimates), 24% had normal body mass indices (BMI), 17% were underweight, and the rest were either overweight or obese. The baseline ICU malnutrition rate was 69%. Malnutrition screening, and assessment of risk and biochemical indicators were not done routinely. Majority (92%) had baseline dietary prescription but only 69% had specific energy and macronutrient breakdown, all done through predictive weight-based equations. Nutritional supplies arrived within 8 hours in 65% of patients. Feeding was initiated within 24–28 hours in 94% of patients. Commercial formula was the preferred type of enteral nutrition (EN). Total duration on nothing-by-mouth (NPO) (hours) throughout ICU stay was significant. Supportive measures to improve gastro-intestinal (GI) tolerance were not standardized. Common factors in delaying feeding initiation were hemodynamic instability, fasting for procedures and GI bleeding. Throughout the ICU stay, fasting for procedures, hemodynamic instability and mechanical ventilation (MV)-related factors were common. ICU mortality rate was 19% and average length of ICU stay was 5 days.&#x0D; Conclusion. Malnutrition is still prevalent in our ICUs and is affected by suboptimal healthcare practices. Staff - to-patient ratios, malnutrition risk screening and assessment, dietary referrals, documentation and minimizing interruptions in nutritional care provision needs improvement. A system review and establishment of a nutrition team is imperative.

A STUDY TO ASSESS THE KNOWLEDGE, ATTITUDE AND PRACTICE OF STAFF NURSES REGARDING MALNUTRITION AND NUTRITIONAL CARE OF HOSPITALIZED CHILDREN IN A TERTIARY CARE HOSPITAL BELAGAVI, KARNATAKA

Food is the main fuel that runs a human body, both in health and illness. Food and Nutrition play a major role in the prevention of almost all diseases and promotion of health. Unfortunately at the global level, India is being placed among the highest ranked countries on the basis of number of malnourished children1. Childhood is a crucial period where we need to pay some extra attention for the nutritional needs and nutritional care of a child, as it acts as a strong pillar for his/her growth and development and prevention of malnutrition. Despite many medical advances over the past 20 years, the prevalence of malnutrition among hospitalized children has not decreased. Since the staff nurses spent more time with patients than any other healthcare workers and the patient recovery is greatly affected by the quality of care these nurses provide to their patients in all the aspects of care, including the nutritional aspect. Present study was conducted to assess the Nurses’ Knowledge, Attitude and Practice towards nutritional care of the hospitalized children, in order to ensure quality nutritional care for hospitalized children who are at risk of developing malnutrition or who are already victims of it. A nonexperimental descriptive research design was adopted to carry out the present study on a sample of 40 staff nurses working at a Tertiary care hospital of Karnataka by administering MKAP questionnaire. The results of the study showed that majority of the staff nurses 28(70%) had average knowledge and neutral attitude regarding malnutrition and nutritional care among hospitalized children , while as 7(17.5%) had good knowledge and positive attitude and 5( 12.5%) of them had poor knowledge and negative attitude regarding malnutrition and nutritional care among hospitalized children. The majority of the staff nurses 25(62.5%) showed neutral practice regarding malnutrition and nutritional care among hospitalized children, while as 10 (25%) showed beneficial practice and 5 (12.5%) of them showed non-beneficial practice regarding malnutrition and nutritional care among hospitalized children. In the present study the association of Levels of KAP with demographic characteristics of the staff nurses was calculated by using chi-square test and no association was found between the two except for gender. The study concluded that most of the staff nurses are having average knowledge and neutral attitude and practice towards malnutrition and nutritional care of hospitalized children

An audit on nutrition delivery and patients' outcome in the intensive care unit

Rationale: Optimal nutrition delivery in the intensive care unit (ICU) is essential in reducing complications and improving patient's outcome. The audit aims to survey prevalent enteral nutrition practices in a Singapore hospital and improve the unit's quality of nutrition care.

The Quality in Nutrition Care (QUINCE) model: development of a model based on Australian healthcare consumer perspectives.

Primary healthcare is the ideal setting to address diet-related disease through delivery of nutrition services. However, quality nutrition care has not previously been defined from the healthcare consumer perspective. To explore, and develop a theoretical model of, healthcare consumer expectations of quality nutrition care in the primary healthcare setting. A qualitative study design collected data describing healthcare consumer expectations of nutrition care. Consumers were recruited through social media and research networks, screened, and invited to participate in a semi-structured telephone interview. Interviews explored experiences and views of nutrition care. Interviews were thematically analysed, and informed development of a model using an iterative process. Twenty-three healthcare consumers participated in an interview. Five themes were identified. The Quality in Nutrition Care consumer model developed from these themes comprised 5 interconnected components, these being: (i) quality nutrition care occurs within an integrated societal system; (ii) quality nutrition care is available, accessible, and affordable; (iii) quality nutrition care is up-to-date and evidence based; (iv) quality nutrition care is underpinned by positive relationships; and (v) quality nutrition care is personalized to consumer needs. The consumer-derived model of quality nutrition care can be used by providers to inform activities that enhance primary healthcare practice, outcomes, and impact. The model has important implications for primary healthcare system reform and policy. Future research should explore the provision of dietetic services in primary care, with specific focus on factors that influence quality care, and investigate how quality is monitored and improved.