Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.
OBJECTIVE
To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards.


BACKGROUND
A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality.


METHODS
Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants.


RESULTS
Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results.


CONCLUSIONS
Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed.


CONCLUSIONS
The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework.
Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden.
Mona
M
Persenius
Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden.|Department of Nursing, Gjøvik University College, Elverum, Norway.
Marie-Louise
ML
Hall-Lord
Faculty of Health, Science, and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden.|Department of Nursing, Hedmark University College, Elverum, Norway.
Bodil
B
Wilde-Larsson
Centre for Health Care Sciences, Örebro University Hospital, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.|Department of Quality and Patient Safety, Lindesberg Hospital, Lindesberg, Sweden.
Eva
E
Carlsson
D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009718:Nurse Administrators; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D012042:Registries; D020521:Stroke / Q000178:diet therapy* / Q000451:nursing; D011795:Surveys and Questionnaires; D013548:Sweden
Senior Alert registry; cross sectional study; management; nutritional organisation; quality indicators; stroke patients