Nutritional education for doctors and nurses: What is the impact?

Abstract

The under-recognition and under-treatment of malnutrition in the UK, which costs the NHS an estimated £13 billion each year, has been linked to poor provision of nutritional education in medical and nursing academic programmes. The present study aimed to investigate whether the introduction of a mandatory nutritional education programme for doctors and nurses at a district general hospital would influence knowledge and attitudes related to the recognition and treatment of malnutrition and whether subsequent changes in clinical practice would be observed. It was hypothesised that knowledge, attitudes and clinical practice would all improve following training. A repeated measures design was used to assess knowledge and attitudes among junior doctors and registered nurses before and after an educational intervention using a quantitative questionnaire. A clinical audit of compliance with national clinical standards, in the form of the inpatient nutritional screening policy, was used to assess clinical practice and was a repeat of an audit conducted 12 months before. Both audits were compared for analysis. Baseline knowledge scores were below 55% for both doctors and nurses. Baseline attitude scores reflected an overall positive attitude towards nutritional screening for both groups. The results showed that both knowledge and attitudes improved significantly following training for both occupational groups. The audit identified that national clinical standards were not complied with. However, following training, statistically significant improvements were observed in compliance with the nutritional screening policy between 2008 and 2009. Specifically, the audit found that an additional 8.2% of patients were screened on admission to hospital and an additional 50.1% of patients were screened weekly during admission. Figures of prevalence of malnutrition also increased from 15.79% in 2008 to 19.21% in 2009 but were still lower than national statistics. It is recommended that all NHS Trusts implement mandatory nutritional education programmes for doctors and nurses to support clinical governance. Limitations and considerations for future research are discussed.