Assisting Patients with Feeding PDF

Preview

Summary

Download Assisting Patients with Feeding PDF

Description

Assisting Patients with Feeding Nursing practices are becoming more diverse than ever, in ways that nobody could have imagined a generation ago. They are tasked with broader range of health care responsibilities. Modern nurses are not just a great caregiver but a great innovator. It is imperative for nurses to take additional treatment responsibility, change the nature of the services provided, get a reasonable skill and be willing to assume responsibility for the new practice (Charles, 2013). One of the nurse's special roles is to help patients with feeding. Various works of literature on enteral feeding, parenteral feeding and oral feeding of patients are discussed in this writing. Assisted feeding (hand feeding or oral feeding) is the type of feeding provided by nurses to assist patients in feeding with food or fluid due to patient’s ailment (Connie et al. 2014). When people are sick or vulnerable, nutrition becomes more important in controlling their recovery. The inability of physical weakness can be complicated by mental impairment, communication problems and inability to demonstrate hunger or lack of access to food. Helping patients in eating and drinking is at the heart of care and is required in rapid recovery and rehabilitation of patients. This is a complex medical intervention requiring knowledge and skills (CNA Skill, 2017). The section 1.1 of Nursing and Midwifery Council (2015) mandated nurses to treat people especially patients with respect, compassion, love, and kindness. Nurses have received bad impression from the public in recent years due to lack of care for patients. One of the reasons attributed to decline in caring nurses is the emphasis on degree-entry nursing, but there is no reason for educationally skilled Nurses to be uncaring. The real reason for Nurses uncaring and loss of compassion may be more complex (Caroline, 2011). Section 1.3 of the code enjoins Nurses to avoid making assumptions and recognize diversity and individual choice of patients in their care. The key to Nurses cultural competency in patients is built on respect, thoughtfulness, calm, uprightness, smartness, interest, and forbearance. The societal customs, beliefs, or rules of engagement should not be given priority in order to take care of patients from all countries, religion belief, doctrine, and culture (Epner & Baile, 2012).

1

Al Kalaldeh et al. (2015) observe that the role of nurses in providing the tube feeding for patients is typically inserting feeding tube during mealtime. They pointed out that the role also include upkeep of the tube, nutrition administration, anticipation and recognizing of complications related with this form of therapy and support in the assessment of the patient's reaction to tube feeding. The nurses' understanding and skill in the nasogastric tube feeding and subsequently care of nasogastric tube are critical in clinical area to ensure safety and health of the patients. Fulbrook et al. (2007) pointed out that nurses have inadequate involvement in establishing evidence procedures and evaluating existing guidelines for enteral feeding because of insufficient knowledge or background or time restrictions that reduce their confidence in developing practice. Another challenge is the shortage nursing staffs which is a general trait of intensive care unit (ICU) worldwide. Al-Hawaly et al. (2016) assess nurses’ performance regarding feeding patients with the nasogastric tube in Ismailia General Hospital and found out that nearly threequarters(71%) of the studied nurses had a reasonable level of understanding regarding administering feeding to patients. The study was in accordance with Shahin (2012) who argue that there is a high level of correlation between participants (Nurses) scores of understanding about nasogastric tube and practice. Also, Yalcin et al., (2014) discovered that nurses who conducted nutritional assessment activities of patients had a greater understanding of patient’s nutrition than those who did not. In contrast, Ahamed & Mondal, (2014) explained that three-quarters of studied nurses had no understanding as regards Ryle's tube feeding. They also noted that 62.2% of the studied nurses had the unsatisfactory level of practice as regards administering feeding to patients. This is in accordance with Metwaly (2013), who mentioned that levels of practice as regards to pre-administration of medication via nasogastric tube were unsatisfactory less than two third and approximately one-half of the studied sample incorrectly practice this procedure. Al-Hawaly et al. (2016) observes that the fear of being infected with disease, increased assignment, no reward for hard and good work, fatigue, shift time not enough, no promotions for hard working and efficient nurses, lack of nursing personnel, low salary, and also there are no opportunities for attending training course especially on enteral feeding are factor that influences Nurses performance with nasogastric tube

2

feeding understanding. This was corroborated by Efstathiou et al. (2011), who points that lack of competent nursing personnel, too busy and time executing procedures are related factors that are perceived as obstacles to follow standard procedures. Ogita et al. (2013) study on the understanding of tube feeding practices for grownup adult patients between Japanese nurses, the results confirm that most of the nurses believe that reason for tube feeding was to improve quality of life (QOL) in the elderly patients who has problem eating. The result also shows that Nurses decision on tube feeding of patients including percutaneous endoscopic gastrostomy (PEG) is not related to their clinical understanding or experiences in nursing practise. McClave et al. (2009) and Ridley & Davies (2011) agrees that enteral feeding should be initiated without delay in patients who are seriously ill and who cannot feed through oral nutrition within 24-48 hours of admission to intensive care unit. In a study by Marik and Zaloga (2001) on early enteral feeding in reducing infectious and non-infection complication, length of stay (LOS) and death rate in comparison with late enteral feeding. The analysis was conducted from 15 randomized controlled trials (RCTs) to verify the effectiveness of the early versus late enteral feeding. The results of the study showed that early enteral feeding was associated with a less amount of infections (RR 0.45, 95% CI 0.30-0.66 p...