To have and to hold nutritional control: balancing between individual and routine care. A grounded theory study.
OBJECTIVE
Gaining insight into nutritional processes can help nurses and other staff in their work. The aim was to provide a theoretical understanding of the concerns and strategies of nutritional nursing care for patients with enteral nutrition in intensive care units.


METHODS
A grounded theory approach was used. Observations of patient's nutritional care and twelve interviews with eight registered nurses and four enrolled nurses were conducted.


METHODS
The study was carried out in one intensive care unit at a medium sized hospital in Sweden.


RESULTS
The substantive theory developed included the core category "To have and to hold nutritional control - balancing between individual care and routine care". The core category was reflected in and related to the categories "knowing the patient", "facilitating the patient's involvement", "being a nurse in a team", "having professional confidence" and "having a supportive organisation". Finding a balance between individual care and routine care was a way of enhancing the patient's well-being, security and quality of care.


CONCLUSIONS
To have and to hold nutritional control over the patient's nutrition was found to be a balancing act between individual care and routine care. Organisation and teamwork are both challenging and supporting the provision, maintenance and development of nutritional care.
Wentzel Persenius
Mona
M
Department of Nursing, Karlstad University, Karlstad SE-651 88, Sweden. mona.persenius@kau.se
Wilde-Larsson
Bodil
B
Hall-Lord
Marie Louise
ML
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration* / Q000523:psychology; D004750:Enteral Nutrition / Q000451:nursing*; D005260:Female; D006272:Health Facility Environment; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D015596:Nutrition Assessment; D010358:Patient Participation; D017009:Professional Autonomy; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden