Exploring the role of the nutrition nurse specialist in an intestinal failure tertiary referral centre

Clinical nurse specialists in nutrition: A systematic review of roles and clinical experiences

BACKGROUND/SCOPE

The Clinical Nurse Specialist in Nutrition is a professional capable of providing specialist clinical assistance and leadership-related clinical nutrition. To date, although their role has already been identified, there is still uncertainty about how this figure can actually fit into the various global health systems. The purpose of this review is to clarify and define the role of this professional aimed at analysing clinical experiences and data from nutrition scientific societies.

METHODOLOGY

A systematic literature review was conducted using the Prisma Statement in the Cochrane Library databases and subsequently in PubMed, Embase, CINAHL, Scopus and Web of Science. In addition, a manual search of studies published in Google Scholar was conducted for the analysis of 'grey literature'. Out of 3,320 identified records, 20 studies were included in the present review. [Correction added on 06 June 2024, after first online publication: The preceding sentence has been corrected from "Out of 2,348 identified records, 21 studies were included in the present review." to "Out of 3,320 identified records, 20 studies were included in the present review" in this version.] RESULTS: The development of specific training, certification and qualification protection courses is contributing to the development of this professional in various hospital and community clinical contexts. The clinical experiences identified have shown that this figure is able to provide specialist assistance by offering high levels of safety, efficacy and quality of the care provided.

CONCLUSIONS/ IMPLICATIONS FOR NURSING

The implementation of nurse nutrition specialist, to date, is still limited at the global level, and training programmes coordinated between scientific societies and nursing universities could be the basis for the development of this specialization in countries where today this figure is not yet present.

Development of the ward nurses' discharge-oriented dietary support scale for older adult patients in Japan

AIM

This study aimed to develop a ward nurses' dietary support scale, including physical, psychological, and social background factors in preparation for older adult patients' life after discharge.

METHODS

We conducted a cross-sectional study using a self-reported questionnaire. Scale items were created based on a conceptual analysis, and refined by a Delphi survey. In total, 696 nurses across 16 acute care hospitals in Japan were eligible to participate. The questionnaire comprised 51 items that used a five-point Likert-type scale. These items were evaluated using exploratory factor analysis. Reliability was evaluated using Cronbach's alpha and intraclass correlation coefficients (ICC). Pearson's correlation coefficients were calculated to determine concurrent validity, and construct validity was analyzed using confirmatory factor analysis.

RESULTS

Altogether, 241 surveys were included in the data analysis; 236 nurses participated in both the test and the retest. The exploratory factor analysis identified 20 items from three factors as follows: "Assessment for healthy eating behavior," "Adjustment of the living environment, including family and caregiver, together with other professions," and "Continual frailty assessment." In the confirmatory factor analysis, the fitness indices supported these results. Cronbach's alpha was 0.932 and ICC was 0.867 for the overall scale. In the concurrent validity, the three factors had a moderate correlation (r = 0.295-0.537, P < .01 and r = 0.254-0.648, P < .01), except for one subscale.

CONCLUSIONS

We developed a ward nurses' dietary support scale, including physical, psychological, and social background factors in preparation for older adult patients' life after discharge. Its reliability and validity were confirmed.

Nutrition nurse-led outpatient 'hot' clinics are efficient and cost-effective: a retrospective single-centre evaluation

BACKGROUND

Nutrition nurses work in multidisciplinary and nurse-led outpatient clinics. The daily nutrition nurse-led 'hot' clinic in this study sees patients for enteral or home parenteral nutritional support. Appointments may be for routine procedures or emergency reviews.

AIMS

This study aimed to identify activities and procedures performed in the nutrition nurse-led clinic, identifying admission avoidance activity.

METHODS

Nurse-held records for the period from April 2018 to March 2020 were reviewed retrospectively. Data were collated in an Excel spreadsheet for analysis and results are presented using descriptive statistics.

RESULTS

Records covered a total of 590 patients, 294 men and 296 women with a median age of 59 years, and 606 procedures. Key activities were troubleshooting enteral feeding tubes (29%), insertion of fine-bore nasogastric feeding tubes (18%) and management of home parenteral nutrition issues (11%). The presenting problem or issue was resolved in 90% of patients, with no need for hospital admission or additional medical review.

CONCLUSION

The nutrition nurse-led clinic provides an efficient and cost-effective service, preventing hospital admission and emergency department attendance in most cases.

Identifying the nutrition support nurses' tasks using importance-performance analysis in Korea: a descriptive study

PURPOSE

Nutrition support nurse is a member of a nutrition support team and is a health care professional who takes a significant part in all aspects of nutritional care. This study aims to investigate ways to improve the quality of tasks performed by nutrition support nurses through survey questionnaires in Korea.

METHODS

An online survey was conducted between October 12 and November 31, 2018. The questionnaire consists of 36 items categorized into 5 subscales: nutrition-focused support care, education and counseling, consultation and coordination, research and quality improvement, and leadership. The importance-performance analysis method was used to confirm the relationship between the importance and performance of nutrition support nurses' tasks.

RESULTS

A total of 101 nutrition support nurses participated in this survey. The importance (5.56±0.78) and performance (4.50±1.06) of nutrition support nurses' tasks showed a significant difference (t=11.27, P<0.001). Education, counseling/consultation, and participation in developing their processes and guidelines were identified as low-performance activities compared with their importance.

CONCLUSION

To intervene nutrition support effectively, nutrition support nurses should have the qualification or competency through the education program based on their practice. Improved awareness of nutrition support nurses participating in research and quality improvement activity for role development is required.