Evaluating nutritional management of adult inpatients requiring assisted feeding at Kenyatta national hospital medical wards

Abstract

Background: Malnutrition is among the leading conditions that lead to disease complications and prolonged hospital stay among the hospitalized. Patients that require assisted feeding will need partial compensatory or supportive educative medical interventions that will help improve patient outcome. Kenyatta National Hospital a teaching and referral hospital receives medical patients from other facilities as referral-in and neighbouring area, who may be seen at the medical outpatient clinic or be admitted to medical wards. Admissions can be from the accident and emergency department or from the various medical outpatient clinics. Objectives: The broad objective was to evaluate the nutritional management of adult patients requiring assisted feeding at Kenyatta National Hospital (KNH) medical wards. The specific objectives were to determine their bio-demographic profile, to assess the nutritional status using anthropometric measures, to establish patients’ perception and nurses’ perspective on nutritional management of adult in-patients requiring assisted feeding. Methods: This was a cross-sectional design study. The independent variables were Patients’ characteristics: age, gender, educational level, economic status, expectations and institutional factors: timing of meals, food presentation, and staff assistance. The dependent variables were patients’ nutritional management. The outcome was based on level of nutrition. The study was conducted at KNH medical wards among in-patients requiring assisted feeding. Systematic and random sampling methods were adopted and questionnaires were used for data collection. Out of a sample size of 187 patients and 89 nurses, 153 patients and 67 nurses were studied. Data was coded and analyzed using Statistical Package on Social Science (SPSS) software. Quantitative data was analyzed using descriptive statistics methods of percentiles, mean, mode and standard deviation while inferential statistics were Chi-square, Fishers exact test and t-test. The study was conducted according to the KNH/UON/ERC regulations upon being permitted. Results and conclusion: The patients demographic profile revealed that patients requiring assisted feeding were more likely to be females, of low educational level, self employed with monthly income <Ksh5000. Formally employed patients were more likely to be malnourished. A majority of the patients were within normal ranges of BMI, with 24.2% being malnourished. Patients were partially satisfied with meals quality. Patients were rarely screened for xvi malnutrition. The most interrupted meal by medical procedures was breakfast (76.2%) and the most frequent feeding assistant was the nurses. Recommendation: The researcher recommends that KNH administration to lay emphasis on initial assessment of patients’ nutritional status and during hospital stay as recommended by BAPEN. Since good nutrition is important in preventive medicine, the admission period should be used to educate all patients on nutrition. Regular surveys of customer satisfaction should be introduced. The researcher also recommend that an investigation be made on the factors associated with nutritional status of formally employed