Challenges of Maintaining Adequate Patient/Client Nutrition - Essay Example

Challenges of Maintaining Adequate Patient/Client Nutrition Abstract This paper analyzes research problem regarding challenges incurred by nurses and other patient caretakers in their bids to maintain adequate nutrition. Nutrition and hydration are fundamental human requirements that ought to be the main issue of the nurse in the care of a patient or client. This essay’s objective is to attempt and respond to the following questions: What are the challenges in maintaining adequate nutrition? What can nurses and other caretakers do effectively and efficiently assist the client meet his or her nutrition needs? These and similar queries are the basis of the decision-making procedure, whether the objective is on general nursing or particularly on nutrition. The data would be gathered from a survey and by mode of a Questionnaire and analyzed on the modified. The data collected would be gauged on relevancy to challenges and compared to literature research to make an adequate inference. Key words: Adequate nutrition, patients/clients needs, and challenges. Background Information The study of nutrition in relation to patients has been done by many researchers; however, this study objective is to look at the challenges that make it impossible to provide and maintain adequate nutrition to patients. Challenges of maintaining adequate nutrition when dealing with patients are many. In this research paper, we consider various empirical literature researches to analyze the challenges also use other approaches to collect data. If the dietary state of the client is unbalanced or inadequate the effect of therapeutic medicinal interventions can be unproductive therefore nutrition is as essential as medication in the recuperation from wounds, chronic diseases, surgical operation and infections. The lack of a nutritional diet can lead to undernourishment which is taken to be a major danger for morbidity and humanity among patients. The challenges of adequate nutrition are broad from financial to eating habit of the patient. This essay is to elaborate more on these challenges and try to highlights means of maintaining adequate nutrition. Literature review Many researchers have tackled the problems of nutrition in regards to patients care. In view of theses empirical literature, this research paper aims to demonstrate the lapse in professionalism of nurses. The challenges are broad; however literature provision has given various aspects of the challenges. In this paper, we review and compare the realities of the challenges. Many articles states that the role of nurses in ensuring that patients receive adequate nutrition is hampered with nature of their many roles. The Roper, Tierney and Logan representation for nursing declares that the nurse has a key role, within the multidisciplinary group, in making sure that patients get food, fluids and sufficient nutrition whilst under the care and health learning regarding a nutritious diet (Holland et al 2008). It is essential for a care provider to have applicable physiological knowledge and comprehending of what makes a balanced meal and different ingredient of food groups. Assisting patients to get meals is regarded as a core nursing skill that they and other care givers need to nurture for the health and safety of patients as well as deterrence of diseases. The nurse does a big task in meeting the nutritional requirements of patients by evaluating them on admission, monitoring, assisting, referrals and advice. It is the duty of the nurse to guarantee that joint care with other multidisciplinary experts such as rehabilitation nurses, dieticians, social workers and professional therapists is executed as soon as possible in matters of malnutrition, obesity disease or anorexia (Coates, 2013 Pg. 215). This portrays a challenge in adequate nutrition provision due overwhelming duties and priorities concerns. The Caroline Walker Trust of 2004 proposes that nurses should be available and involved at mealtimes, with regard to individual preferences, ensuring that patients are seated in an upright posture to encourage usual digestion and making the surroundings pleasant by eradicating commodes and bed pans to encourage a good appetite. However, this is a challenge in implementation due to the scarcity of nurses to manage patients on a one to one ratio. Nurses, in partnership with the catering staff should value individual cultural choices like providing meat free meals for vegetarians, Kosher for Jews and acknowledging any food allergies and fanaticism. Cultural beliefs are challenges and adherence to them is also costly. Further more, healthcare institutions or even home care may not accommodate adequately theses needs. Nurses should spot patients who require assistance using the red serving dish initiative as directed in the nutrition expert. Due to multi-task duties nurses are involved in; these special treatments have made provision of adequate nutrition difficult. It is essential for the nurse to employ good interpersonal communication abilities with the patient to encourage them to take meals properly. The nurse must also check that all documentation are well recorded such as care strategies; food and fluid balance plan as it is a better way of communicating with colleagues and gives an apparent nutritional result. It is documented that a red tray initiative is a nice form of identifying patients who requires assistance (Webb, and Copeman, 2000, Pg 177). It gives them a chance to be conscious that meeting nutritional needs of patients can be more demanding as the patient refuses to be helped in feeding. Barriers encountered by nurses include: lack of proper nutritional training, lack of nursing time due to many duties, poor communication, respect and trust within the multidisciplinary expertise. The above challenges encountered by the nurses equally apply to nutrition provision. Nurses or care providers are expected to have adequate knowledge on nutritional status of the patients. To attain optimal nutritional position, intake may require to be attuned upward or downward. For example, when the objective is recovery from sickness or surgical procedure, nutrition therapy aims at meeting increased necessities for protein, calories and other nutrients. Clients who do not meet their nutritional requirements may experience delayed or complicated recovery from poor health, and their reactions to medical treatments and medicine therapies may be reduced. Know how a challenge in many fields of specialization is thus proper nutrition provision by nurses is not exceptional. In wellness strategies, when most favorable nutritional status means disease avoidance, the nutritional aim is frequently to make sure that intake does not surpass requirement. The emphasis is on preventing excesses of fat, calories, cholesterol, saturated fat, and sodium to lessen the risk of chronic illnesses such as heart disease, diabetes, hypertension, and obesity. However, these strategies do not have mutually limited nutritional priorities (Williams, 2003, Pg. 110). Environment where patients are taken care of also pose a challenge to nutrition provision. Some hospital patients need restrictive meals such as low-sodium diet, and some wellness patients have nutrient consumption below their needs such as not adequate calcium or fiber. Therefore, precedence for all patients is to eat or obtain a sufficient and appropriate intake of carbohydrates and nutrients based on their own person needs. Just what is a sufficient and appropriate consumption of nutrients and calories and how to attain that intake is established by analyzing facts to identify real or potential nutritional troubles. The decision-making procedure continues with objective setting, executing a plan, and assessment. While the diet technician or dietitian may shoulder the majority of accountability for the dietary care of hospitalized clients deemed to be at reasonable to high nutritional challenge, low-risk hospitalized clients and patients in other environments such as corporate wellness, home health and parish nursing may be transferred to the nurse. Additionally, it may be the nurse who monitors clients to establish the existing stage of risk and who emphasizes diet counseling. As such, they are intimately engaged in all matters of nutritional care. Different clients/patients have different nutrition provision and these variances must be considered by nurses. This further, complicated their duties and hinders maintenance of adequate nutrition provision for patients. The above literature review leads to the formation of the research question for the project. Research question: What are the challenges that the nurse or care providers face in their bids to provide and maintain adequate patient nutrition? This question assists in research progress by engaging a collecting data through conventional modes to answer the questions. Hypothesis: Challenges experienced in nutrition provision are the same for nurses and other home base patients care takers. Null Hypothesis: The challenges are real and faced the involved parties though on different extent. Research Project Plan The objective of this research is to analyze the data gathered on the research field and the information extracted from the empirical literature articles. In this part, we illustrate and analyze the major ideas utilized in the background of study based on an appraisal of accessible hypothetical and empirical research. This study will employ quantitative and qualitative research method to collect and analyze information from 20 respondents, to determine challenges experienced nutrition provision. The samples of 20 respondents are randomly selected based on gender, age, and marital status. The topic requires to substantiate or refute the offered hypotheses and to benefit from the objectives of the Qualitative study method applied in gathering, inferring and analyzing data obtained from the field through interviews, questionnaires, and observations or those accessible from the secondary sources (Goetz, & Mahoney, 2012). It may also embrace the use of focus teams in case moderately small numbers of respondents are questioned. Qualitative research in this research is used to help in interpretation of the data and is anchored on occurrences and theory analysis. The researcher’s work tries to establish the major challenges nurses or health care providers encounter in their bids to establish stable nutrition provision (Creswell, 2000). This will be achieved through the use of the questionnaire to the arbitrarily chosen respondents; to gain a deeper understanding of nutrition’s’ challenges and how they would stakeholders to resolve the problems. Challenges are properly documented with appropriate tools and put into consideration. The face to face questionnaires engage questioning or meeting chosen respondents. In addition, qualitative research techniques assist the researcher to achieve inclusive and rich data in the written form through the survey and give a possibility for an observation that is important during interpretation. Quantitative research method, on the other hand, scrutinizes data collected through structured questions with fixed answer options and involves a moderately large number of informants (Creswell, 2000). This method assists to adequately give details of the data gained through quantitative technique. Equally, the method assists the researcher to deeply compare the relationship between independent and dependents attributes in order to make objective inferences. Finally, the research methods assist to check hypotheses set in this research job. Thus use of both quantitative and qualitative method gives a chance for competent compilation of data and thorough analysis and interpretation of the data to make dependable deductions. Population/Sampling The respondent would be selected randomly in regards to age or sex. Twenty would be the population to sample. A number of care provider will be sampled to get their feedback on what challenges they under go. Patients/clients also must be sampled to get comparative responses. This criterion would assist in getting valid and comparative data to make a conclusive report. Data collection The technique for gathering data would involve structured questionnaire to collect relevant data from the 20 selected respondents. The questions section would comprise at least 10 questions to determine the level of care providers and patients’ knowledge on the challenge of nutrition. The assortment of a prearranged questionnaire is because they are relatively easy and quick to generate, permit researchers to attain large numbers of informants within a short span of time and are easy to interpret and code. This method of data collection is selected because of the following merits: It is very factual and practical. Large data can be collected from a large number of informants quickly and comparatively cost effective. It can be completed by the researcher or by any number of persons with limited effect to its legality and dependability. The consequences of the questionnaires can normally quick and easy to quantify by either a researcher or by use of a software package. Questionnaires can be investigated more scientifically and objectively than other forms of research methods. When data has been accumulated, it can be utilized to compare and contrast other research and may be utilized to gauge alteration. Positivists presume that quantitative data can be used to develop new theories and / or review existing hypotheses (Ackroyd and Hughes, 2009). The questionnaire is simple to normalize since all informants are questioned the same questions in a similar way making the research reliable owing to the fact that everyone in the sample responds to precisely to same questions. The closed questions lessen vagueness in answering questions and are simpler in making inferences based on the research data. The collection methods were not limited to the questionnaires; however, other recognized literature extract have been utilized to make this research. Ethic; The method of questioning respondents is ethical since it is voluntary and the information gathered is strictly used for the research purpose. The information cannot be disclosed to other sector or used for a different study. Analysis After data has been collected it is paramount to be analyzed and presented in formats easy for analysis. An important tool, which can greatly help in data presentation, is Excel software. This program assists in tabulating the data to make their presentation easily to understand. Excel is readily obtainable and has necessary properties to effect the data presentation. During the process setting or planning of the nutrition dietary nurses are faced with various challenges from financial status to cultural beliefs. Obtaining dependable and accurate information on what the patient usually eats is far-off more hard than it seems. Yet it is fundamental information to assist in ensuring nutritious diets are given to the clients. Eating is very personal and individuals often get distrustful when asked about their eating routines. Even though the nurse may only be needed to take notes and record about the diet. Simply questioning the patient whether the person is on a diet. May probably not provide accurate or adequate information to establish what the patient eats. First of all, a patient may deduce that leading question as telling her or him to be on a diet. It is always very challenging to get information from patients in regard to what they eat. This has been a nagging issue for nurses since they find it difficult to gauge and determine the best diet for patients who are unwilling to share information. Both over-the-counter and prescription medicines have the prospective to affect and be hampered by nutritional status (National Institute for Health and Clinical Excellence, 2006). Occasionally drug-nutrient connections are the projected action of the medicine. At other times, adjustments in nutrient consumption, metabolism, or secretion may be a disregarded side effect of drug treatment. Priority setting in case of patients sometimes is biased on medication part but less on nutrition. This is because patients often visit health facilities for treatment and thus nurses pay much attention to medication. However, this should not be so as nutrition is part and parcel of treatment of a patient. What is the patient’s most pressing health challenge and how can nourishment assist in its treatment? This is a very vital question, which should be considered by the nurses during their documentation of client’s details. Does the patient require more protein and calories to meet increased requirements or a limited intake to treat chronic illness? For example, the priority for a nursing institution resident with heart complication who is experiencing noticeable weight loss is not to continue a low-fat meal but to boost calories so as to stop or reverse the weight deterioration. Equally essential is that those calories and other nutrients have to be in a usable form: patients get a little help from the food they cannot assimilate and absorb (Chicago Dietetic Association, 2005, Pg 132). Finally, whenever potential it is a main concern to provide calories and nutrients through meals that are well-known to and favored by the client. It is also important to prioritize what the patient requires to learn about nutrition. The patient who is a recently diagnosed type two diabetic with uneven eating habits, a high fatty level, osteoporosis and obesity has a lot of nutritional worries (American Dietetic Association, 2002, Pg 221).. Rather than propose that he or she keep away from sugar, limit red meat intake, cut fat, time meals consistently, eat more vegetables, switch to soft margarine, eat oatmeal, use canola oil, and drink more milk, it is wise to prioritize: developing a regular eating outline and simply reducing quantities are the most key first steps. The documentation of the nurses, influence the care to be given to a patient in regard to medication and nutrition. Based on the information collected and deduced, actual or probable nutritional challenges are stated in nursing assessment (Potter, Langhorne and Roberts, 2008, Pg. 100). Nursing assessment in hospitals and long-term care amenities provide written records of the client’s status and act as a structure for the preparation of care that follows. The diagnoses correlate directly to nutrition when changed nutrition is the trouble or indirectly when alter in intake will assist to handle a non nutritional problem. In wellness situations, documentation may be casual or missing as in the case of a single opportunity such as community wellbeing fair. In those examples, nursing diagnoses may be psychologically noted but physically unrecorded. This becomes a challenge when documentation is not well taken or some changes are made on the course of administration. Teaching patient to maintain nutritional diet at home is a big challenge since they often fail to follow in instructions. Compared with healthy clients, patients in a medical setting may be more adaptive to nutritional recommendation particularly if they feel improved by doing so or are scared of deterioration or complications (Coulston, 2013). But hospitalized clients are also fond of confusing nutrition messages. Time used up with a dietitian or diet technician educating about a balanced meal maybe short or interrupted. Even if it represents a whole new intake style that is best accomplished by making chronological changes, nourishment counseling in the hospital is frequently limited to one or two periods with the diet technicians (Stump, 2002, Pg. 266). The client may not even be acquainted with what questions to inquire until long after the technician has gone. The patient’s capability to incorporate new information may be interrupted by pain, anxiety, medication, or a distracting situation. Hospital diets or menus that vary from release orders add to the perplexity. Nutrition counseling by dietitians and nurses is more successful and competent than that undertaken by nurses or dietitians (DUDRICK, 2011, Pg. 105). Limitation of the Study The research limitation would be accessing the data from a private hospital and also home based patients. Though this limitation does not mean the research cannot be carried out successfully. This is a challenge since most of the care providers do not take proper heed to this requirement; thus end up failing in adequate nutrition provision. In all settings, it is fitting to assess the client’s dietary status so that suitable goals and interventions can be developed to correct real or potential imbalances (Dudek, 2010, Pg. 357). It is very subjective to judge patients by their size of the body before administering or advising dietary meals. Most patients have been miss-judged and their nutrition intake interfered with since they look in a particular manner. Conclusion The challenges of maintaining adequate patients’ nutrition are brought about by various factors as analyzed above. Monitoring and teaching patient to maintain nutrition ha two sides; first, in hospital challenges are due to other duties nurses undertake. However, greater challenge is witnessed at home based patients who lack close supervision from nurses and dieticians also have poor family eating habit influence. Although everybody agrees that it is significant to identify definite and potential dietary problems, there is no commonly accepted, definitive instrument to do so. Often professional conclusion is as essential as objective criteria. The process of evaluation involves collecting and analyzing statistics. Nurses are in an ultimate position to screen patients for nutritional problems through a first nursing record and physical assessment. Patients deem at low or no threat for nutritional problems may require only to be checked regularly for any worsening in nutritional status. Table of Contents Table of Contents 13 Bibliography ACKROYD S. AND HUGHES J. A., (2009) Data Collection in Context (2009)Revised edition Longman AMERICAN DIETETIC ASSOCIATION (2002) Position of the American Dietetic Association: Total diet approach to communicating food and nutrition information. Journal of the American Dietetic Association, 102(1), 100–108. Pg 222 BRITISH ASSOCIATION OF PARENTERAL AND ENTERAL NUTRITION (2003). The Malnutrition Universal Screening Tool (MUST). BAPEN: Redditch. CHICAGO DIETETIC ASSOCIATION, The South Suburban Dietetic Association, Dietitians of Canada. (2000). Manual of clinical dietetics (6th ed.). Chicago: American Dietetic Association. COATES VE, (2013). Are they Being Served? 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