Using intervention mapping to develop an outpatient nursing nutritional intervention to improve nutritional status in undernourished patients planned for surgery.

Autor: van Noort HHJ; Department of Nutrition, Physical Activity and Sports, Department of Surgery, Gelderse Vallei Hospital, P.O. Box 9025, 6710, HN, Ede, The Netherlands. Harm.vanNoort@radboudumc.nl.; Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands. Harm.vanNoort@radboudumc.nl., Heinen M; Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands., van Asseldonk M; Department of Gastroenterology and Hepatology - Dietetics and Intestinal Failure, Radboud University Medical Center, Nijmegen, The Netherlands., Ettema RGA; Julius Center for Health Sciences and Primary Care, University Utrecht Str. 6.131, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands.; Research Center Health and Sustainable Living, Utrecht University of Applied Sciences, P.O. Box 12011, 3501, AA, Utrecht, The Netherlands., Vermeulen H; Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.; Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands., Huisman-de Waal G; Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2020 Feb 27; Vol. 20 (1), pp. 152. Date of Electronic Publication: 2020 Feb 27.
DOI: 10.1186/s12913-020-4964-6
Abstrakt: Background: Undernutrition in surgical patients leads to a higher risk of postoperative complications like infections and delayed recovery of gastrointestinal functions, often resulting in a longer hospital stay and lower quality of life. Nurses at outpatient clinics can deliver nutritional care during outpatient preoperative evaluation of health status to ensure that patients are properly fed in preparation for hospital admission for surgery. However, nutritional nursing care was not determined in research yet. This paper describes the structural development of an Outpatient Nursing Nutritional Intervention (ONNI).
Methods: A project group followed the steps of the Intervention Mapping. The needs assessment included assessment of delivery of nutritional care and nutritional care needs at two anaesthesia outpatient clinics of an academic and a teaching hospital. Also, outpatient clinic nurses and patients at risk for undernutrition were interviewed. Determinants resulted from these methods were matched with theories on behaviour change and nutritional support.
Results: Both patients and nurses were unaware of the consequences of undernutrition, and nurses were also unaware of their roles with regard to nutritional support. The intervention goals were: 1) enabling surgical patients to improve or maintain their nutritional status before hospital admission for surgery, and 2) enabling nurses to deliver nutritional support. The ONNI was developed for outpatients at risk for or with undernutrition. A training was developed for nurses. The ONNI included the five following components: 1) identification of the causes of undernutrition; 2) provision of a nutritional care plan including general and individually tailored advice; 3) self-monitoring of nutrient intake; 4) counselling and encouragement; and 5) support during a telephone follow-up meeting. The intervention and training were tested. A multifaceted implementation strategy was used to deliver the intervention in daily practice.
Conclusions: Despite the unique position of the nurses at outpatient clinics, nurses were unaware of their role with regard to nutritional care. The ONNI was developed and implemented along with a training program for nurses. The test confirmed that the training can improve nurses' knowledge, skills, and sense of responsibility for nutritional support. The intervention may empower patients to actively improve their nutritional status.
Databáze: MEDLINE
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