Nutrition: a hard nut to crack. An exploration of the knowledge, attitudes and activities of qualified nurses in relation to nutritional nursing care.

Provision of adequate nutrition is recognized as essential, yet malnutrition continues to be reported in patients admitted to hospital. The effects of malnutrition in hospital patients have been well documented; however, most work relating to nutritional management has been produced by members of Nutrition Support Teams, nurse specialists and interested clinicians, whilst the majority of hospitals are still without such specialist posts. This study used two data collection methods to gain information about the attitudes, nutritional knowledge base and nutrition-related nursing care in a large trust hospital in the South of England. A survey of care plans for documentation of nutrition-related nursing activities, carried out on the day of discharge for all patients from five wards over a period of a fortnight (totalling 141 sets of documentation), was followed by a questionnaire to all qualified nurses on these and a further four wards (110 nurses). Results demonstrated that nurses generally felt that nutritional assessment was primarily their responsibility. Whilst there was evidence of knowledgeable and proactive nursing care, it also appeared that there were fairly widespread deficiencies in the knowledge, communication and co-ordination required to ensure consistent good practice.