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

Autor: Roelof Ettema, Getty Huisman-de Waal, Hester Vermeulen, Harm H J van Noort, Maud Heinen, Monique van Asseldonk
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Health Knowledge
Attitudes
Practice

Prehabilitation
Outpatient clinic
Nutritional Status
Nursing
Health behaviour change
Development
Nurse's Role
Health administration
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
03 medical and health sciences
Intervention mapping
Nursing care
0302 clinical medicine
Quality of life (healthcare)
All institutes and research themes of the Radboud University Medical Center
Ambulatory Care
Medicine
Humans
030212 general & internal medicine
Nutritional support
Aged
2. Zero hunger
030504 nursing
business.industry
lcsh:Public aspects of medicine
Health Policy
Nursing research
Preoperative care
Malnutrition
lcsh:RA1-1270
Undernutrition
Middle Aged
3. Good health
Surgery
Needs assessment
Female
Health Services Research
0305 other medical science
business
Research Article
Zdroj: BMC Health Services Research, 20, 1
BMC Health Services Research
BMC Health Services Research, 20
BMC Health Services Research, Vol 20, Iss 1, Pp 1-16 (2020)
ISSN: 1472-6963
Popis: 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: OpenAIRE