Providers' and Nurses' Knowledge and Perception of Adult Malnutrition in a Local Intensive Care Unit

Abstract

Malnutrition is a disproportionate amount of calories, fats, vitamins, and minerals that the body requires to maintain health. This includes individuals that are underweight to those that are overweight. Unfortunately, individuals that require critical care are at risk for malnutrition. There are many complications from malnutrition in critical care patients that may increase mortality, cost, length of stay, and readmissions. This Doctor of Nursing Practice project was a mixed methods convergent parallel methodology, one group, pre-test/post-test design. The study embodied a quality improvement project for a local hospital. The purpose of the project was to assess providers' and nurses' knowledge and perceptions of adult malnutrition in critical care and determine if providing education increased comfort, compliance, and advocacy with protocols, programs, and guidelines. The study took place at Flagstaff Medical Center (FMC) for a total of two weeks. The participants of the study were FMC critical care providers and nurses in Flagstaff, Arizona. The survey included a demographic questionnaire, pretest, educational handout, and posttest. A two-tailed paired test was used to evaluate answers based on a six-point Likert scale. Results demonstrated a significant increase in knowledge, comfort, and advocacy in the organization's protocols, programs, and guidelines. Open-ended questions were coded and themed. Common themes that emerged about improvement of malnutrition and reasons for malnutrition in critical care included nothing by mouth management, delayed nutrition start, preexisting malnutrition, and early nutritional assessment. Recommendations based on the results of the quality improvement project include creating an organizational culture that values nutrition, using a multidisciplinary approach when assessing and addressing malnutrition, using a screening tool, and rapid implementation of nutrition.