Developing a nursing diagnosis for the risk for malnutrition: a mixed-method study.
Silvia Brunner, Hanna Mayer, Matthias Breidert and 2 others
PMID 33476490WHAT IT FOUND
A proposed nursing diagnosis flags older inpatients at malnutrition risk through poor appetite, swallowing or denture problems, missed mealtime support, medications, and care dependency.
Key findings
01The proposed diagnosis identifies healthcare workers' attitude and culture, inappropriate mealtime environment, impaired oral cavity status, impaired swallowing, polypharmacy and multimorbidity, appetite loss, and care dependency as risk factors.
02In 22 nursing records, 9 had no nutrition-related nursing diagnosis, and nutrition-related diagnoses were set on average on the fourth day after admission.
03Interviews and observations reported eating barriers such as not being asked about appetite, missing or poorly fitting dentures, unsuitable food texture, pain at mealtimes, and relatives not being involved.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The nursing diagnosis was developed in one 200-bed Swiss hospital, so it may not fit other settings. Only 22 patients were included, purposively selected, and 15 of 37 approached refused or were unexpectedly discharged, limiting transferability. Patients who were terminally ill, tube-fed, receiving parenteral nutrition, or unable to sustain a German dialogue were excluded, so the findings may not apply to those groups. The quantitative record analysis was descriptive and small, and correlations do not show that better documentation causes better outcomes. The diagnosis was content-validated, not tested for effect on intake, weight, complications, or recovery. The literature review was narrative and included studies with low to high risk of bias.
Declared interests
The supplied metadata says the work received non-U.S. government research support, but the article text does not state funding or author conflicts.
The easy way to misread this
Do not read this as proof that the proposed diagnosis improves nutrition. It was developed and content-validated with 22 patients from a single hospital, not tested in an outcome study.