Role In Nutritional Care Research Articles

Evaluation of Malnutrition Knowledge among Nursing Staff in the Czech Republic: A Cross-Sectional Psychometric Study

Construct : The Knowledge of Malnutrition – Geriatric 2.0’ (KoM-G 2.0) instrument was designed to quantify nursing staff malnutrition knowledge in inpatient medical and rehabilitation care facilities, as well as home health care. It has been used to assess grasp of current clinical practice guidelines and proficiency in addressing issues related to malnutrition. It provides insight into familiarity with and capacity to tackle issues pertaining to malnutrition in clinical practice. Furthermore, it has been used assess the effectiveness of educational interventions aimed at improving nursing professionals knowledge and awareness of malnutrition. Background : The quality of nursing education affects malnutrition risk assessment, monitoring of food intake, and effectiveness of nutrition care. Improvements in malnutrition education require determining the current level of knowledge and benchmarking with other countries. In the Czech Republic, no nationwide assessment of nursing staff malnutrition knowledge has ever been conducted. Approach : The purpose of the study was to translate the KoM-G 2.0 instrument, gather initial validity evidence, and evaluate nursing staff knowledge of malnutrition in inpatient medical, rehabilitation care facilities, and home care in the Czech Republic. All inpatient healthcare facilities and home healthcare facilities in the Czech Republic were invited to participate. The Czech version of the internationally standardized KoM-G 2.0 (KoM-G 2.0 CZ) was used to assess nursing staff malnutrition knowledge between 3 February 2021 and 31 May 2021. A total of 728 nurses began the questionnaire, and 465 (63.9%) of respondents completed it and were included in the study. Data analyses examined instrument difficulty, discriminability, and reliability, as well as sources of variation in knowledge scores. Findings : The psychometric characteristics of the KoM-G 2.0 CZ instrument included the difficulty index Q (0.61), the discriminant index (ULI 0.29, RIT 0.38, upper-lower 30% 0.67), and Cronbach alpha (0.619). The overall mean of correct answers was 6.24 (SD 2.8). There was a significant impact of educational attainment and nutrition training on KoM-G 2.0 CZ scores. Conclusions : Our findings provide initial validity evidence that KoM-G 2.0 CZ is useful and appropriate for assessing malnutrition knowledge among Czech nursing staff. Our research identified gaps in knowledge and examples of good practice in understanding malnutrition that can be applied internationally. The knowledge of academic nurses was greater; therefore, we suggest they play a key role in nutritional care. We recommend continuous education to improve understanding of malnutrition in this setting.

Knowledge, attitudes and practices of intensive care unit nurses towards nutritional care in critically ill patients: A descriptive cross-sectional study

Introduction: In recent years, there has been a growing concern about the lack of adequate nutrition Knowledge among nurses. Nutrition training in the medical curriculum and for healthcare professionals is contradictory, inadequate, and weak. Nurses are one of the most reliable sources of nutritional information for patients; and yet, little research has been done so far on nurses’ information regarding their important role in nutritional care. Our study is designed to assess the current level of Knowledge, attitudes, and practices of nurses in intensive care units (ICUs). Methods: A four-part questionnaire was used in this study. This descriptive cross-sectional study was conducted from July 2019 to July 2020. The sample size consisted of 110 nurses based on the statistical data obtained from the nursing offices of two hospitals of Tabriz University of medical science including all the nurses working in the ICUs. Thereafter, all questionnaires were re-collected and data were finally analyzed. Results: Results showed that from 110 nurses which were included in this study, 73.6% had high Knowledge, 45.5% had moderate practices, and 58.2% had a positive attitude about nutritional support. Age and level of education had a significant correlation with their knowledge (P=0.005 and P=0.001, respectively). Nursing attitude had a significant correlation with age and the level of education (P=0.03 and P=0.003). And also, nursing practice had a significant relationship with age, work experience in the ICU, and the level of education (P=0.001, P=0.001 and P=0.004, P<0.05). Conclusion: Nurses surveyed in this study had a high knowledge, moderate practice and a positive attitude regarding nutritional care in patients admitted to the ICU.

Role of nutritional care and general guidance for patients with advanced or metastatic gastric cancer.

Patients with advanced or metastatic gastric cancer often suffer from malnutrition, which can have an impact on quality of life, increase the toxicity of chemotherapy and reduce overall survival. Options available to the clinician to manage a patient's nutritional status include screening and assessment of malnutrition at diagnosis, monitoring during the 'cancer journey', early detection of precachexia and the ongoing use of a multidisciplinary team (oncologists, other medical specialists and nutritionists). Because malnutrition is frequently overlooked and under treated in patients with advanced or metastatic gastric cancer, this narrative review focuses on the clinical meaning of nutritional status in gastric cancer and provides general guidance regarding nutritional care management for patients with advanced or metastatic gastric cancer.

Time for nutrition in medical education

AimTo synthesise a selection of UK medical students’ and doctors’ views surrounding nutrition in medical education and practice.MethodsInformation was gathered from surveys of medical students and doctors identified between 2015...

Interventions to prevent and treat malnutrition in older adults to be carried out by nurses: A systematic review.

To identify interventions to prevent and treat malnutrition in older adults, which can be integrated in nursing care, and to evaluate the effects of these interventions on outcomes related to malnutrition. Older adults are at great risk for malnutrition, which can lead to a number of serious health problems. Nurses have an essential role in nutritional care for older adults. Due to a lack of evidence for nursing interventions, adequate nursing nutritional care still lags behind. Systematic review. We searched for and included randomised controlled trials on interventions, which can be integrated in nursing care for older adults, to prevent and treat malnutrition. We assessed the risk of bias with the Cochrane tool and evidence for outcomes with the GRADE. The PRISMA statement was followed for reporting. We included 21 studies of which 14 studies had a high risk of bias. Identified interventions were oral nutritional supplements, food/fluid fortification or enrichment, dietary counselling and educational interventions. In evaluating the effects of these interventions on 11 outcomes related to malnutrition, significant and nonsignificant effects were found. We graded the certainty of evidence as very low to moderate. Although slight effects were found in protein intake and body mass index, there is no convincing evidence about the effectiveness of the four identified interventions. There seems no harm in using these interventions, although it should be kept in mind that the evidence is sparse. Therefore, there is a need for high-quality research in building evidence for interventions in nursing nutritional care. Nurses can safely provide oral nutritional supplements and food/fluid fortification or enrichment, and give dietary counselling and education to older adults, as they are well placed to lead the essential processes of nutritional care to older adults.

NURSES’ OPINIONS AND BELIEFS ABOUT MALNUTRITION IN OLDER ADULTS: A CROSS-SECTIONAL STUDY

Malnutrition in older adults is a frequent and major problem. Despite the fact that nurses have an essential role in nutritional care, they fail to ensure appropriate delivery in preventing and treating malnutrition. For improvement, it is necessary to understand the perspective of nurses about malnutrition. The aim of this study was to gain insight into nurses’ opinions and beliefs about malnutrition in older adults. A cross-sectional study was conducted where nurses working in different health care settings were asked to fill in a survey with twelve questions regarding different aspects of malnutrition. Nurses (n = 557) frequently observe malnutrition in older care recipients, and they consider this as a serious health problem. They believe that prevention and treatment of malnutrition is important and they see screening of malnutrition as a relevant nursing activity. They also consider nutritional care as multidisciplinary. Nurses state their need for education to give adequate nutritional care. Nurses’ opinions and beliefs about malnutrition in older adults is positive, which enhances nurses’ behavior to give sufficient nutritional care to older adults. To gain more benefit in improving nursing activities within nutritional care for older adults, more education is needed targeting nurse professionals and nurse students.

Hospitality within hospital meals—Socio-material assemblages

ABSTRACTHospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host–guest interactions and creating temporary meal communities. However, asymmetrical host–guest relations bound to health and efficiency rationales typical for public meal production-systems contested the hospitality space. Findings indicate that hospitality thinking can be a valuable guiding principle to enable staff and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future.

Rekindling the role of nurses in patients' oral nutrition

Hospital malnutrition is a worldwide problem. A nutritional care policy was evaluated to determine whether nutrition was enhanced by improving patients' access and nurses' supervision of meals. Fourteen pre-audit wards (435 patients) and 20 postaudit wards (422 patients) across three hospitals participated in a pre-post audit and observation study with an examination of documentation. A food satisfaction survey was completed by 226 patients (pre) and 240 patients (post). A modest increase in the proportion of patients receiving supervision with meals (83% pre, 88% post, P = 0.058) was not associated with an increase in consumption (50% or more of meal). Patients report poor appetite in the presence of good to fair food quality. The nurse's role in nutritional care was defined. Protected mealtimes supported by nurse managers reorganizing staff mealtimes with assistance from carers, volunteers and other health professionals were endorsed. Nurses must ensure that patient's meal trays are accessible.

Nurturing and nourishing: the nurses’ role in nutritional care

Researchers collaborated with clinicians, consumers and dietitians to develop a policy defining how nurses could support their patients' nutritional care. A high prevalence of hospital malnutrition has been reported in Australia, Europe and the UK. A patient's nutritional status can deteriorate during admission. Malnutrition can increase complications, length of stay, mortality rates and health care costs. As the nursing role has become increasingly complex, traditional nurturing activities such as serving the patients' meals have devolved to other categories of staff leaving the role of nurses in their patients' nutritional care ill-defined. The research team systematically reviewed relevant research literature using the principles of qualitative metasynthesis to identify appropriate nursing strategies that would assist in reducing the prevalence of hospital malnutrition. The policy was developed using a systematic review approach: devising a clinical question, searching the literature, appraising research evidence, analysing existing policy documents, synthesising evidence into dominant themes and once the policy was drafted, initiating a wide ranging consultation and ratification process. A literature search located 147 articles. Forty articles were identified as being within the scope of the clinical question. Most were reports of audits or observation studies. The dominant themes were developed into standards that assisted nurses in supporting the oral nutrition of their patients. These included the following: a focussed mealtime, management of mealtime environments, management of staff mealtimes and a designated nutrition support nurse in each clinical area to monitor and evaluate the implementation of the policy. There is a distinct role for nurses that will assist in reducing the prevalence of hospital malnutrition but successful implementation can only occur with the support of the multidisciplinary team. This policy provides a framework to define and invigorate nursing's role in supporting the patient's nutrition care.

The importance of nutrition support in the head-injured patient

The nutritional requirements of head-injured patients are significantly increased. This is related to the hypermetabolic and hypercatabolic response to head injury, and is multifactorial. Head-injured patients are at high risk of malnutrition, due to raised nutritional requirements and the likelihood of neurological deficit affecting the ability to take in sufficient nutrients orally. Early and often prolonged nutrition support is needed to improve clinical outcomes in the head-injured population. Nutrition support may be oral, or via artificial means depending on the needs of the individual. Adequate nutrition support relies heavily on appropriate screening and monitoring. The commitment of the entire multidisciplinary team is needed to ensure that nutrition support measures in the head-injured patient are successful. Nursing staff play a key role in nutritional care; nutrition link-nurses are particularly valuable in ensuring that good nutritional care is given.

Adapting eating patterns to address problems of malnutrition

Malnutrition can be a significant problem for adults with chronic diseases in the community. Early recognition of those individuals at risk of malnutrition helps to prevent further decline in nutritional status. Treatment needs to consider all aspects of nutritional intake, including ordinary food and nutritional supplements as well as artificial means of nutritional support. A brief review of malnutrition is outlined and the practical changes that can be made in food intake to boost nutritional intake are suggested. Small changes in eating patterns and food intake have the potential to play an important role in nutritional care alongside the use of prescribable supplement drinks.

Points: Traumatic neuropathy of second cervical spinal nerves

<h3>Aim</h3> To synthesise a selection of UK medical students’ and doctors’ views surrounding nutrition in medical education and practice. <h3>Methods</h3> Information was gathered from surveys of medical students and doctors identified between 2015 and 2018 and an evaluation of nutrition teaching in a single UK medical school. Comparative analysis of the findings was undertaken to answer three questions: the perceived importance of nutrition in medical education and practice, adequacy of nutrition training, and confidence in current nutrition knowledge and skills. <h3>Results</h3> We pooled five heterogeneous sources of information, representing 853 participants. Most agreed on the importance of nutrition in health (&gt;90%) and in a doctor’s role in nutritional care (&gt;95%). However, there was less desire for more nutrition education in doctors (85%) and in medical students (68%). Most felt their nutrition training was inadequate, with &gt;70% reporting less than 2 hours. There was a preference for face-to-face rather than online training. At one medical school, nutrition was included in only one module, but this increased to eight modules following an increased nutrition focus. When medical students were asked about confidence in their nutrition knowledge and on advising patients, there was an even split between agree and disagree (p=0.869 and p=0.167, respectively), yet few were confident in the UK dietary guidelines. Only 26% of doctors were confident in their nutrition knowledge and 74% gave nutritional advice less than once a month, citing lack of knowledge (75%), time (64%) and confidence (62%) as the main barriers. There was some recognition of the importance of a collaborative approach, yet 28% of doctors preferred to get specialist advice rather than address nutrition themselves. <h3>Conclusion</h3> There is a desire and a need for more nutrition within medical education, as well as a need for greater clarity of a doctor’s role in nutritional care and when to refer for specialist advice. Despite potential selection bias and limitations in the sampling frame, this synthesis provides a multifaceted snapshot via a large number of insights from different levels of training through medical students to doctors from which further research can be developed.

Whole time consultants' views on private practice.

<h3>Aim</h3> To synthesise a selection of UK medical students’ and doctors’ views surrounding nutrition in medical education and practice. <h3>Methods</h3> Information was gathered from surveys of medical students and doctors identified between 2015 and 2018 and an evaluation of nutrition teaching in a single UK medical school. Comparative analysis of the findings was undertaken to answer three questions: the perceived importance of nutrition in medical education and practice, adequacy of nutrition training, and confidence in current nutrition knowledge and skills. <h3>Results</h3> We pooled five heterogeneous sources of information, representing 853 participants. Most agreed on the importance of nutrition in health (&gt;90%) and in a doctor’s role in nutritional care (&gt;95%). However, there was less desire for more nutrition education in doctors (85%) and in medical students (68%). Most felt their nutrition training was inadequate, with &gt;70% reporting less than 2 hours. There was a preference for face-to-face rather than online training. At one medical school, nutrition was included in only one module, but this increased to eight modules following an increased nutrition focus. When medical students were asked about confidence in their nutrition knowledge and on advising patients, there was an even split between agree and disagree (p=0.869 and p=0.167, respectively), yet few were confident in the UK dietary guidelines. Only 26% of doctors were confident in their nutrition knowledge and 74% gave nutritional advice less than once a month, citing lack of knowledge (75%), time (64%) and confidence (62%) as the main barriers. There was some recognition of the importance of a collaborative approach, yet 28% of doctors preferred to get specialist advice rather than address nutrition themselves. <h3>Conclusion</h3> There is a desire and a need for more nutrition within medical education, as well as a need for greater clarity of a doctor’s role in nutritional care and when to refer for specialist advice. Despite potential selection bias and limitations in the sampling frame, this synthesis provides a multifaceted snapshot via a large number of insights from different levels of training through medical students to doctors from which further research can be developed.