Food for thought: delivering effective nutritional care

摘要

The Essential Skills Clusters (ESCs) form an integral part of the Standards for Pre-registration Nurse Education (Nursing and Midwifery Council, 2010).These standards form the basis of nursing curricula nationwide. Two ESCs are pertinent to this issue: clusters four nutrition and fluid management' and two 'organisational aspects of care'. Education providers are obliged to develop programmes that enable students to develop the knowledge, skills and attitudes to enable them to perform care according to these standards. In relation to cluster two, this includes anatomy, physiology, pathophysiology plus constituents of a balanced diet, nutritional assessment etc. Students also undertake simulation activities to learn how to assist patients with their dietary and fluid needs at a fundamental level and learn skills to support more technical care such as parenteral and enteral nutrition. These skills are then role modelled, supervised and assessed in clinical placements by mentors. However evidence suggests that health professionals consistently report inadequacies in nutritional knowledge (Murphy and Girot, 2013).While acknowledging the value of the ESCs, Morison et al (2010) added that nutrition and hydration needs, particularly for vulnerable patients, remains poorly covered both in nursing and medical programmes. Moreover it is possible that in practice placements accountability for this area of care is not clear. For example food and fluid choice, administration and monitoring of intake of those able to eat and drink involve a wide range of support, including from administrative and specialist dietetic staff.