Introduction: Despite the high prevalence of malnutrition in patients at all levels of healthcare, early prevention and treatment of malnourished patients are often neglected and overlooked in clinical practice. The aim of this systematic literature review was to identify the factors considered most important by healthcare professionals in the identification and treatment of malnourished patients or those at risk of malnutrition.
Methods: A systematic literature review of qualitative research was conducted. Documents published in scientific journals in English from 2011 to 2021 were searched in the PubMed (MEDLINE), CINAHL and ProQuest databases. The results were analysed with a thematic analysis of qualitative research findings.
Results: From the search set of 1010 results, 7 sources were included in the final analysis. Factors identified by health professionals as important in the identification and treatment of malnourished patients in clinical practice were grouped into five themes: unclear organizational structure; indefinite structure of nutritional care; poor continuity of nutritional care; lack of knowledge and skills of health professionals; lack of time and human resources.
Conclusions: Health policy must provide resources for nutritional care for patients at all levels of health care on the initiative of the highest professional bodies at the state level. To improve the nutritional care of patients in clinical practice, the management of health care institutions must promote and enable the professional and organizational establishment of clinical nutrition as a regular medical activity of the institution, develop clinical nutritional pathways, and promote evidence-based clinical practice and interprofessional collaboration.
Uvod: Kljub visoki razširjenosti podhranjenosti pri pacientih na vseh ravneh zdravstvenega varstva sta zgodnja preventiva in zdravljenje podhranjenih ali prehransko ogroženih pacientov v klinični praksi pogosto zapostavljena in spregledana. Za razvoj potencialno učinkovitih strategij za uvedbo prehranskega presejanja in učinkovite prehranske terapije za paciente s prehranskim tveganjem je pomembno poznati že raziskane dejavnike, ki ovirajo takšno klinično prakso. Namen sistematičnega pregleda literature je bil analizirati dejavnike in ovire učinkovitega prepoznavanja prehransko ogroženih pacientov, ki so jih pri svojem delu prepoznali zdravstveni delavci.
Metode: Uporabljen je bil sistematični pregled literature, izveden v podatkovnih bazah PubMed (MEDLINE), CINAHL in ProQuest. Iskalni pojmi so bili: medicinske sestre, zdravstveno osebje, prehransko presejanje, prehranska ocena, podhranjenost, odnos, ovire in posredniki. Vključili smo raziskave objavljene v znanstvenih revijah, v angleškem jeziku, od leta 2011 do 2021. Rezultati so bili analizirani s tematsko analizo ugotovitev kvalitativnih raziskav.
Rezultati: Iz iskalnega nabora 1.010 zadetkov smo v končno analizo vključili 7 virov. Dejavnike, ki so jih zdravstveni delavci opredelili kot ključne pri prepoznavanju in obravnavi prehransko ogroženih pacientov v klinični praksi, smo združili v petih temah: klinična prehrana ni organizacijsko strukturirana kot del zdravstvene dejavnosti; struktura prehranske podpore je nedorečena; prehranska podpora ni kontinuirana; pomanjkljivo znanje in usposobljenost zdravstvenih delavcev na področju klinične prehrane; pomanjkanje časa in kadrovskih virov.
Zaključki: Zdravstvena politika, na pobudo najvišjih strokovnih organov na ravni države, mora zagotoviti resurse za prehransko obravnavo pacientov na vseh ravneh zdravstva. Za izboljšanje prehranske obravnave pacientov v klinični praksi morajo vodstva zdravstvenih ustanov spodbujati in omogočati strokovno ter organizacijsko umeščanje klinične prehrane kot redno zdravstveno dejavnost zavoda, razvijati klinične poti za prehransko podporo pacientov, spodbujati na dokazih temelječo klinično prakso in medpoklicno sodelovanje strokovnjakov.
Keywords: barriers and accelerators; health professionals; nurses; nutritional care; nutritional screening.
© 2022 National Institute of Public Health, Slovenia, published by Sciendo.