Reducing The Incidences Of Malnutrition Nursing Essay

Reducing The Incidences Of Mal provender Nursing Essay-Reducing the incidences of malnutrition that a good deal occurs during access to hospital has been a priority inwardly the breast feeding c be duty for many years. There have been various ex designingations for this such(prenominal) as drop of staff, patients non able or ar un instinctive to admit they get assistance, pitiful use of esteemment tools and care pathways. A key ingredient in the prevalence of patients presenting with undernourishment is the disturbances patients endure during meal terms, such as protect rounds, non urgent medical interventions, housekeeping activities and visitors. This essay will look the incidences of malnutrition, and those who are most at risk and the neuters that have been made to reduce such incidences. flip vigilance should be regarded as an ongoing process, which requires good communication, planning, lordly leadership and cooperation. This essay will endeavor to explore th e vary counsel processes, leadership and squad management skills used in the utensilation of saved mealtimes. It will explore the negative aspects and problems encountered when implementing a transmute and the ongoing management skills required to principal(prenominal)tain such miscellanys.For many patients admitted to hospital, in particular the elderly, malnutrition is a commonplace occurrence. It is the nurses fundamental duty of care to provide patients with the highest of care weeable, a major requirement for any human organism to survive and depart a healthy life is the intake of a healthy upstanding some(prenominal) diet, be that by conventional methods or artificial measures suitable for the patients allege of health at that time (Royal College of Nursing 2007). Studies into hospital malnutrition show that as many as four protrude of ten elderly patients admitted to hospital are already malnourished and as a result of a hospital admission as many as six out of ten elderly patients, become malnourished, their situation worsens and their illness very often escalates (Age C at a timern 2006 BAPEN 2007). The NHS Improvement Plan (2004) discipline standards to deal with the increasing incidences of malnutrition inwardly hospital settings it has become apparent that these examples of good practice recommendations have non been implement in every hospital in the country, as incidences of malnutrition touch to exist. Davidson and Scholefield (2005) reports that inadequate nutrition basis lead to long-lasting hospital stays, impairs the convalescence of patients and sum ups financial costs some(prenominal) hospitals have indeed planned and utilize alternates to reduce such incidences but on the whole have had express success. The authors found that constant interruptions from drug, rounds, clinical activities and lack of nursing staff organism on the ward at mealtimes (due to lunch breaks coinciding with mealtimes) all accounted fo r patients being provided with very little or on occasion no nutritional intake at any given mealtime. Savage and Scott (2005) does agree with this contr all oversy to some extent but argues that it is all to easy to blame nursing staff alone, it is the righteousness of to each one individualist NHS trust to implement managerial removes and policies and ensure that they are monitored, evaluated and improved to provide the best care possible for each patient. Mamhidir et al (2007) argues that since the implementation of protected mealtimes in some hospitals in that respect is substantial prove to suggest that patients, particularly the elderly benefit vastly patients gained weight, healing time reduced, were discharged earlier and mealtime experiences were a more loving experience for patients as well as nursing staff. Mooney (2008) argues that there is test to suggest even after hospital trusts have been presented with unarguable induction that malnutrition is a major p roblem and a catalyst for longer hospital stays, lone(prenominal) 43 percent of those trusts have non yet provided evidence that they have implemented schemes in order to reduce hunger and malnutrition. The infirmary Caterers Association (2004) go on comment that mealtimes should not primarily focus on the provision of nutrition, it in like manner makes way for kindly interaction between patients and carers, they that comment that in general the quality of the food provided is not the issue, the softness of the patient to be able to feed themselves is far more the worrying issue. Council of Europe (2003) comment that hospitals should be designed to be patient centred, ensuring that the rake of nutrition is flexible and all deliverance of care is set within a frame kick the bucket all staff should workplace together in partnership to ensure that incidences of poor nutrition are dealt with. Repetitive reports of malnourishment is evidence enough to suggest that current pract ices are no longer working, variegate is a necessary force to ensure incidences are reduced. It is the responsibility of the leader to ensure this is tackled (Age Concern 2006). qualify Management spate be described as the process of developing a planned tone-beginning to change within an organisation. The objective should be to maximise the collective benefits for all stakeholders mingled in the change and minimise the risk of failure implementing the change. Change involves assessment, planning and evaluation changes in which people are nursed should forever be focused on the benefits patients will receive if change is implemented ( internal Institute of wellness and Clinical Excellence, 2007). Welford (2006) writes that there are many theories which explore the need for change the goal should be the provision of the highest quality of care, each individual involved in the delivery of such care should work together, be committed and supportive of each new(prenominal) during times of change. Change within a squad which leads to newborn practices and ideas affects each individual other than it butt end be a very daunting task for some and for others it is embraced to allow for personal development and the sharing of knowledge (Murphy 2006). There are many theories which uses steps or phases that can evaluate if a change is needed and if the changes that are implemented work. For the purpose of this essay the author refers to a popular hypothesis developed by Lewin in the 1950s which requires trine stages to implement rough-and-ready change the acceptance and participation of all those involved in the area requiring change. The first phase, unremarkably referred to as the unfreezing stage of this supposition requires the participants to acknowledge the need for change evidence should be provided to encourage new thinking and beliefs about current practices. Hallpike (2008) writes that there is evidence to suggest that squads can be divided into g roups who have their take in individual opinion on certain regimes, practices and care deliverance. This can be said for the provision of nutrition to patients. In this particular study the author reports that some police squad members did not think there was a problem with the current provision, some were not convinced that changes would be made and others did not have faith in a holistic approach across the team up. In this situation it is the responsibility of the team leader to persuade all the team members that the need for change is necessary in order to provide the best usefulness possible, that the whole team work towards a common goal. Welford (2006) discusses the second phase of Lewins theory describing this stage as the moving stage, allowing individuals to voice their own ideas, experiment with assorted regimes, it allows time for reflection, to discuss validating or negative findings. Past practices whitethorn have seen some team leaders take over the belief that employees were seen to work better when the leader provided strict job descriptions and a clear plan of what was expected of them their opinions and ideas were not of value to the overall success of a team. major (2002) argues that for a leader to adopt such thinking will solely lead to flaws and a feeling of negativity within a team the leader should adopt good communication skills and openness to allow for effective team building, positive group dynamics, all working efficiently and productively. Dennis and Morgan (2008) suggests that although change is the responsibility of the service provider, input from the service exploiter is without doubt a valuable tool in assessing if a change is working for the great good. Feedback, regardless of being positive or negative ascertains if the change has been a positive one. If the new change has a detrimental affect to the service user then the change has been a negative one, this requires a knuckle under to the freezing stage to allo w the team to make further changes to increase the benefits to the service user. The authors further comment that managers should be seen as advocates for the service user it should be the responsibility of the manager to challenge team members over poor practice, poor attitudes and resistance to change for the better. Conflict within a team leads to unrest, a disbelief that change is for the greater good leading to a dysfunctional team. The third phase of Lewins theory can be comm tho referred to as the refreezing stage, where new ideas and behaviours become a new or common practice. Pearce (2007) argues that to name this phase as such denotes that the change remains static, leaders should continuously strive to make changes for the better, communication across the whole team allows for individuals points of view to be exposed and discussed feedback on how a new change is working is necessary in order to achieve the highest levels of quality care. leading styles become a key issue when developing, implementing and upholding change. Motivation of staff also plays a key role in the acceptance of change leaders should demonstrate that they are a good role model, adopt a friendly attitude towards team members, accepting of criticism and be willing to provide positive feedback, when the team endeavour to believe in and implement the change (Darlington 2006). Corkindale (2009) argues that leaders need balance their role within a team to ensure that they do not become too over familiar with individual team members, as this may lead to team members relying too heavily on the leader to make all the decisions and liberty may be compromised.Murphy (2006) writes that leaders need to adopt a style of leadership that suits the workforce a laissez-faire approach can be seen as the leader not taking into account individual team members ideas, work ethics and commitment seriously, it can lead to a team feeling devalued and unorganised. The National Institute for Mental Healt h (2007) further suggests that leaders who show their commitment, by working alongside their colleagues, adopting and maintaining the changes themselves demonstrates a leader who is at the forefront in the deliverance of quality care. They further suggest that each leader will bring their own set of ethics, life experiences and education to a team, will often adopt their own style of leadership that may be a mixture of several styles moulded to suit the team and the area of practice they are employed to manage. Opportunities for team members to voice their opinions and concerns are invaluable they are after all the main implementers of the change and will have be the first to recognise if the change has gained positive or negative results. The change can only work if leaders allow for reflection, discussion and adaptation of the change to suit each individual involved in the change process. A change that is touchy to implement or maintain will end in failure, this leads a team adop ting negative feelings and a resistance to change in the future.Goleman (2000) suggests that to adopt an authoritarian approach, can at times be a positive approach to leadership especially if some team members resist change or there is a need to produce quick results. Goffee and Jones (2000) resist with this statement and suggest that a good leader is someone who other people want to follow without bullying, threats or the fear of reprisals they lead by communicating effectively and adopt a style of leadership that allows the team to get a line what is expected of them.RCN (2007) writes that the only way malnourishment can be identified and managed effectively is with effective use of recognised screening tools.Perry (2009) argues that in many cases nursing staff are given the means and tools to assess a patient, but many are inadequately trained to understand the findings of the assessment or are unwilling to involve other health professionals in the care of the patient. A multi disciplinary approach to tackle such problems should be used. Protected mealtimes have been proven to be useful to not only the patient but to the whole care team, it allows for assessment in areas such as speech and language, mental health issues and other physical problems which can affect the nutritional intake of individuals. South Staffordshire Primary Care assertion (2009) reports that protected mealtimes affects and involves all staff within in the organisation from physiotherapists, municipal staff, maintenance staff through to outside professionals such as social workers. It involves all areas of clinical practice where patients require nutritional intake, not only for patients who are unable to feed themselves but for those patients who require and deserve a quiet, interruption free period to eat, drink and relax.To maintain and monitor the change process and may require several attempts before the target is reached. takes time and may not always be successful first time . National Patient Safety Agency (2008) states that many clinical staff referred to the implementation of protected mealtimes as a hindrance to their daily routine, but once the benefits for patients as well as the staff members were explained they became more compliant and instinct for the need to change.