Aspects of nutritional knowledge, attitudes and practices of nurses working at the surgical division at the Kenyatta National Hospital, Kenya
Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006.
INTRODUCTION: Adequate nutrition is required for patients to improve and maintain their health. Nurses are in one of the best positions to ensure adequate nutrition because of their holistic caring role. The aim of the study was to determine aspects of the current nutritional knowledge, attitudes and practices of registered nurses towards nutritional management of patients. RESEARCH METHODS: This was a descriptive and observational study. One hundred and one out of 160 Kenyan registered nurses working at the surgical division at Kenyatta National Hospital in Nairobi, Kenya successfully completed the study representing a 63% response rate. The 47-item validated questionnaire consisted of 9 socio-demographic questions, 13 questions on nutrition knowledge, 13 questions on attitude and 12 questions on nurses’ practices. RESULTS: The general performance of the registered nurses on the selected aspects of knowledge, attitudes and practices was overall poor. They contradicted themselves on their beliefs in relation to their practices. They did not know their primary role in nutrition care, neither did they know the role played by dietitians/nutritionists and doctors. Twenty-six percent of the registered nurses strongly agreed that it was the nurses’ responsibility to assess the nutritional status of patients compared to 72% who strongly agreed it was the dietitians’/nutritionists’ responsibility and 24% who strongly agreed it was the doctors' responsibility. Eighty-two percent reported that they would refer patients to a dietitian/nutritionist, 18% that they would discuss diet options with the patients, while none of the registered nurses would consult the doctor if they felt that the patient was not receiving adequate nutrition. Seventy-five percent of them suggested that nutritional care of patients could be improved by adopting a multidisciplinary approach and 18% by catering staff feeding the patients. Only 28% reported that nutritional issues were included in ward rounds. Although 72% of the registered nurses reported that it was important to weigh patients on admission, only 43% reported actually weighing patients, of which 59% weighed patients for medication purposes and only 18% weighed patients for nutritional status assessment. The overall nutritional knowledge score was graded as average (57%). The poorest scores were noted for knowledge on clinical nutrition questions (14%) and the highest scores for knowledge on basic nutrition questions (91%). CONCLUSION: Although the nurses regarded nutritional care of patients as important, their practices seemed to contradict their attitudes. Considering the responsibility the nurses are entrusted with regarding patient nutritional care, their current knowledge, attitudes and practices towards nutritional care is a cause for concern. The results of this study provide a basis for continuous nutrition education, well-designed protocols for nutritional status assessment by registered nurses and efforts directed towards improved clinical practice.