‘Prevent undernutrition and prescribe oral nutritional supplements correctly’: an educational intervention for district nurses

Abstract

Aim: The aim of this study was to evaluate district nurses’ (DN) perceived nutritional care and actual level of knowledge about nutritional care before and after a continuing educational intervention. Background: Nutritional treatment is an important part of nursing care, and health professionals responsible for nutritional care for older adults must therefore have sufficient understanding of nutritional problems to provide appropriate support. Previous research has shown that nutritional problems frequently go unrecognized and that health care personnel often lacks knowledge about nutritional care and relevant methods of assessing nutritional status. However, little is known about DNs’ knowledge about nutritional care. Methods: An evaluative study with a study-specific questionnaire administered before and after a 2.5-day continuing educational course for DNs in primary health care in Stockholm County, Sweden. The course was given over a period of two to three months. The questionnaire measured DNs’ perceived nutritional care and actual level of knowledge about nutritional care. Findings: A total of 456 DNs completed the questionnaire both before and after the intervention. Participants’ mean age was 50 years. They had worked a mean of 26 years in health care and 10 years as DNs. Before the intervention, many DNs reported that they did not work with nutritional care in an optimal way. After the intervention, significant improvements were found in perceived nutritional care and actual level of knowledge about the topic. However, not all DNs achieved the learning objectives of the course, so work remains to be done to ensure that DNs have sufficient knowledge of nutritional care to provide appropriate support and correctly prescribe oral nutritional supplements. Conclusions: The study provides new information on DNs’ perceived nutritional care and actual level of knowledge. The result of the intervention helps lay the foundation for good nutritional care for older patients in primary care.

A qualitative exploration of dietitians’ experiences of prescribing oral nutritional supplements to patients with malnutrition: A focus on shared tailoring and behaviour change support

“…Although dietitian support appears to be central when aiming for improvements in ONS prescribing appropriateness, 10 dietitians lack independent prescribing rights in many countries 11,12,13,14 . Accordingly, other ONS prescribing healthcare professionals have expressed a lack of confidence when prescribing ONS 12 and in choosing the ONS that is most appropriate 15 . One solution proposed by Irish general practitioners to better tackle malnutrition and ONS management was greater access to dietetic service 12 .…”

The STAIR OF KNOWLEDGE – Prevention of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes Development and evaluation of the feasibility of an educational intervention

“…Another educational intervention aiming to increase knowledge and improve attitude among healthcare professions regarding identification and management of malnutrition among older persons in primary healthcare showed promising results (109). In another study aiming to evaluate healthcare professionals' level of knowledge before and after a nutritional intervention, in primary healthcare, knowledge improvements were found (110). In other studies, oral educational interventions resulted in positive impact among healthcare professionals regarding oral hygiene among older persons in nursing homes (111), and showed that healthcare professionals in nursing homes were more aware of their own limitations concerning oral healthcare after the intervention, and valued more frequent contact with dental services to a greater extent (112).…”

“…Although the studies highlighted above showed promising results (106)(107)(108)(109)(110)(111)(112)(113), some important issues need to be addressed. For instance, even if education of healthcare professionals regarding pressure ulcers prevention is crucial, a Cochrane systematic review concluded that there was an uncertainty to knowledge increase of pressure ulcers prevention (114).…”