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Importance of nutritional screening in the scope of general nurses
JANÍK, Martin
Current status: Although it was developed and published in many studies pointing to the impact of malnutrition and its relationship to the patient and the economy of the health systems, malnutrition remains a silent guide of hospitalized patients. In the year of 2014, the authors of the study group feedM.E. indicate in their articles the worldwide prevalence of malnutrition as a common and a costly (especially for the elderly). The rate of prevalence of malnutrition in a group of hospitalized patients is around 50%, according to this working group. Objectives: The goal of the project was to describe the methods for screening the patients with nutritional needs interventions by the nurses, the continuity of the care for patients in the risk of malnutrition, transmitting the information about the nutritional status of the patient during his hospitalization and delivery of care to another provider of health services and interdisciplinary co-workers involved in the care of patients in the risk of malnutrition. Methods: The research investigation conducted by the method of the qualitative research. The research subject was the process of detecting malnutrition and continuity of nutritional care for recipients of health services from the perspective of persons providing these services. The research method was chosen a depth interview. The sample of respondents was intentional and the file size was determined by saturation of the collected data. For data processing was used open coding and following categorization of the data which was obtained from interviews. The results were interpreted by using the "showdown". Participants: The request to facilitate the initiation of research has been mostly refused and addressed to the health service providers. Selection of interviewees was intentional by the circle of my former colleagues. With research have expressed their consent five nurses and five dietitians, which are working in the Czech Republic. Results: For identification of patients at the risk of malnutrition, all respondents have described the identification of patients at the risk of malnutrition on admission to the hospital by collecting of nursing history. During the interviews, the respondents have reported the problems both with the absence the reports including detection of patients at the risk of malnutrition from some stations at hospitals, as well as the jurisdictional disputes about the role of the dietitians in patient nutrition at intensive care unit, the complications with material and technical equipment of nursing stations and its applicability for use in specific patients. Also expressed the ignorance of screening tools which are used at the sites of all respondents, including dietitians. The inaccurate ideas of some respondents were in the terms of the skills and the competencies of individual professionals which are involved in the care of patients in the risk of malnutrition. Three nurses of the five indicated that information about the nutritional balance of the patient and their needs should affect the assessment of the patient's overall condition and could lead to changes in the nursing care plan or risk assessment (eg. the risk of pressure ulcers, etc.). Conclusion: The method of providing nutritional care in hospitals, in which respondents are employed, is headed toward pursuing the recommendations of the professional associations. In detail, however, they differ and are often close to the boundaries defined as a legal standards. Breaks are noticeable in continuity of the care, or are put excessive approval procedures, which can lead to delay of required nutritional interventions. Here is a lack of information about the various screening tools and their applicability to the certain groups of patients. Therefore I recommend issuing guidelines by professional society, in the direction of the definition of screening tools and their using in the certain groups of patients, for the healthcare providers in
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