Correction added on 07 November 2014, after first online publication: the title has been corrected for language and terminology.
Barriers to nutritional care for the undernourished hospitalised elderly: perspectives of nurses†
Article first published online: 20 MAR 2014
© 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd
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Journal of Clinical Nursing
Volume 24, Issue 5-6, pages 696–706, March 2015
How to Cite
Eide, H. D., Halvorsen, K. and Almendingen, K. (2015), Barriers to nutritional care for the undernourished hospitalised elderly: perspectives of nurses. Journal of Clinical Nursing, 24: 696–706. doi: 10.1111/jocn.12562
[Correction added on 07 November 2014, after first online publication: this article has been edited for language and terminology.]
- Issue published online: 24 FEB 2015
- Article first published online: 20 MAR 2014
- Manuscript Accepted: 6 JAN 2014
- South-Eastern Norway Regional Health Authority. Grant Number: 2719007
- University Hospital. Grant Number: 2619013
- Department of Health, Nutrition and Management
- focus groups;
- hospital care;
- qualitative study
Aims and objectives
To identify what nurses experience as barriers to ensuring adequate nutritional care for the undernourished hospitalized elderly.
Undernutrition occurs frequently among the hospitalised elderly and can result in a variety of negative consequences if not treated. Nevertheless, undernutrition is often unrecognised and undertreated. Nurses have a great responsibility for nutritional care, as this is part of the patient's basic needs. Exploring nurses' experiences of preventing and treating undernourishment among older patients in hospitals is therefore highly relevant.
A focus group study was employed based on a hermeneutic phenomenological methodological approach.
Four focus group interviews with totally 16 nurses working in one large university hospital in Norway were conducted in spring 2012. The nurses were recruited from seven somatic wards, all with a high proportion of older (≥70 years) inpatients. The data were analysed in the three interpretative contexts: self-understanding, a critical common-sense understanding and a theoretical understanding.
We identified five themes that reflect barriers the nurses experience in relation to ensuring adequate nutritional care for the undernourished elderly: loneliness in nutritional care, a need for competence in nutritional care, low flexibility in food service practices, system failure in nutritional care and nutritional care is being ignored.
The results imply that nutritional care at the university hospital has its limits within the hospital structure and organisation, but also regarding the nurses' competence. Moreover, the barriers revealed that the undernourished elderly are not identified and treated properly as stipulated in the recommendations in the national guidelines on the prevention and treatment of undernutrition.
Relevance to clinical practice
The barriers revealed in this study are valuable when considering improvements to nutritional care practices on hospital wards to enable undernourished older inpatients to be identified and treated properly.