Background: Nutritional care is a basic human right for all people. Nevertheless, undernourishment is known to be\na frequent and serious health care problem among elderly hospitalized patients in Western Europe. Nutritional\ndocumentation contributes to ensuring proper nutritional treatment and care. Only a few studies have explored\nhow nurses document nutritional care in hospitals, and between hospitals and nursing homes. Available research\nsuggests that documentation practices are unsatisfactory. The aim of this study was to explore how nurses\ndocument nutritional treatment and care for elderly patients in hospitals and how nurses and undergraduate\nnurses communicate information about patients� nutritional status when elderly patients are transferred between\nhospital and nursing homes.\nMethods: A qualitative study was conducted using a phenomenological-hermeneutic approach. Data was collected\nin focus group interviews with 16 nurses in one large university hospital, and 11 nurses and 16 undergraduate\nnurses in five nursing homes associated with the university hospital. Participants from the university hospital\nrepresented a total of seven surgical and medical wards, all of which transferred patients to the associated nursing\nhomes. The catchment area of the hospital and the nursing homes represented approximately 10% of the Norwegian\npopulation in heterogenic urban and rural municipalities. Data were coded and analysed thematically within the three\ncontexts: self-understanding, critical common sense, and theoretical understanding.\nResults: The results were summarized under three main themes 1) inadequate documentation of nutritional status on\nhospital admission, 2) inadequate and unsystematic documentation of nutritional information during hospital stay,\n3) limited communication of nutritional information between hospital and nursing homes. The three main themes\nincluded seven sub-themes, which reflected the lack of nutritional screening and unsystematic documentation on\nadmission and during hospital stay. Further the sub-themes elucidated poor exchange of information between hospital\nand nursing homes regarding the nutritional status of patients.\nConclusion: Overall, the documentation of nutritional treatment and care for elderly patients was inadequate in the\nhospital and between health care settings. Inappropriate documentation can create a negative nutritional spiral that\nleads to increased risk of severe health related complications for elderly patients. Moreover, it hinders nutritional\nfollow-up across health care settings.
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