Nurses For Food

Achieving optimal and adequate nutrition is an essential part of holistic patient care and

therefore it should be considered a responsibility of the nurse [1]. According to the nursing diagnoses of NANDA, malnutrition or an imbalanced nutrition is a food intake less than body requirements related to caloric intake that does not meet the activity levels. Malnutrition or undernutrition can develop as a consequence of deficiency in dietary intake, increased requirements associated with disease state, or from a combination of these factors [2, 3].

Malnutrition is a frequent and serious problem in hospital patients. Halfens and colleagues [4] found a malnutrition prevalence of 21.8% in Dutch hospitals. Which corresponds with an undernutrition screening survey in 564.063 patients by Kruizenga and colleagues [5] where 15% of the patients were defined as being malnourished with highest percentages in the medical specialties geriatrics (38%), oncology (33%), gastroenterology (27%) and internal medicine (27%). Only a few days of insufficient dietary intake will already result in a malnourished condition. Consequences of malnutrition are higher infection and complication rates [6], diseases [7-9], low functional status [7], symptoms of depression [10, 11], longer length of hospital stay [12], increased drug use, higher treatment costs [13] and increased mortality [11]. In Dutch hospitals the costs related to malnutrition are estimated on € 1.2 billion per year [14].

Malnutrition is preventable and reversible in most health care settings, if identified early. It is therefore, imperative that nurses are proactive in monitoring and clustering of all available cues to prevent or repair the imbalance between food and required nutrient intake and fluid and electrolyte problems, for all persons considered (at risk of being) malnourished [15]. Once patients are identified as being (at risk of being) malnourished, appropriate interventions should be introduced and monitored, as well by dieticians, as by nurses. Nursing nutritional interventions in hospital however, are not common daily practice. Bavelaar and collegues found that the examination of nutritional status during hospital stay only takes place in one out of three patients (29,9%) [16]. Also, Duerksen and collegues noticed that nutrition education and nutrition knowledge of nurses are to be suboptimal and screening and assessment of nutritional status are recognized as difficult tasks [17]. Effects of basic nursing interventions on malnutrition, e.g. checking that patients are properly fed and hydrated, are considered to decrease malnutrition, but have not been studied well yet [18].

"The objective of this study is to evaluate the feasibility and effectiveness of a nursing nutrition intervention (Nurses for Food) on malnutrition in hospital.
The intervention will be developed according to the Britisch Medical Research Counsil (MRC) framework[19] and the intervention mapping procedure. [20]
"

Stepped Wedge Randomized controlled trial

Nursing nutrition intervention, which actively involve patients in malnutrition care and improve participation in nursing nutritional care.