Nutritional status assessment – a professional responsibility in community nursing

Abstract

Background: According to the recommendations set out in the Norwegian Guidelines for Prevention and Treatment of Malnutrition, community nurses must assess their patients' nutritional risk at the time of admission or registration with the health service, and regularly every month thereafter. Purpose: To investigate how community nurses interpret and uphold sound professional practice with respect to the requirements set out in the Norwegian Guidelines for Prevention and Treatment of Malnutrition. Method: A qualitative study involving analysis of data from two practice development projects. The incremental analysis identified meaning units, sub-themes and themes (32). Four themes were identified and categorised from across the body of material. The data include twelve group interviews with nineteen nurses employed by two different local authorities. Results: Management support is important for the implementation of systematic nutritional screening. The nurses suggested that their familiarity with the patients and their nutritional needs is an important factor with respect to organising the practical arrangements in the home. The nurses felt it was challenging to assess the patient's intake of food and drink around the clock. They found themselves in the field of tension between preserving the home dweller's autonomy, complying with the recommendations for systematic nutritional screening and coping with pressures of time. Conclusion: Nutritional care is a person-centred, practical approach adjusted to the domestic arena. The community nurses ask whether the requirements of the professional guidelines take sufficient account of the home-based context. Close cooperation between managers and staff is required for systematic assessment of nutritional risk to be achieved within the constraints imposed by existing resources.