Ottrey Ella, Porter Judi, Huggins Catherine E, Palermo Claire
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia.
Department of Dietetics, Eastern Health, Melbourne, Victoria, Australia.
Nurs Health Sci. 2019 Mar;21(1):78-84. doi: 10.1111/nhs.12559. Epub 2018 Aug 13.
Nutrition care is a fundamental component of quality health care provided to patients in hospital, yet little is known about the staff who deliver this care and their interrelationships, and how this impacts nutrition care. In this ethnographic study on two subacute wards, 67 h of fieldwork was conducted over 3 months to explore the relationships, roles, and responsibilities of those involved at mealtimes, and the influence on meal provision. Data were analyzed inductively and thematically. Three themes describing ward culture and staff relationships emerged: (i) defining mealtime roles and maintaining boundaries; (ii) balancing the need for teamwork and having time and space; and (iii) effective communication supports role completion and problem solving. Lack of appreciation of workflow enablers and barriers degraded working relationships between staff with and without central roles at mealtimes. The present study informs health-care organizations on building a culture that supports interprofessional collaboration in nutrition care in the subacute setting. All staff need to be aware of their and others' mealtime roles and responsibilities to support a coordinated approach.
营养护理是为住院患者提供优质医疗服务的基本组成部分，但对于提供此项护理的工作人员及其相互关系，以及这如何影响营养护理，我们却知之甚少。在这项针对两个亚急性病房的人种志研究中，在3个月内进行了67小时的实地调查，以探讨用餐时间相关人员的关系、角色和职责，以及对膳食供应的影响。对数据进行了归纳和主题分析。出现了三个描述病房文化和工作人员关系的主题：（i）界定用餐时间的角色并维持界限；（ii）平衡团队合作的需求以及拥有时间和空间；（iii）有效的沟通有助于角色的完成和问题的解决。对工作流程促进因素和障碍缺乏认识，削弱了在用餐时间担任核心角色和未担任核心角色的工作人员之间的工作关系。本研究为医疗保健组织提供了关于在亚急性环境中建立支持营养护理跨专业协作文化的信息。所有工作人员都需要了解自己和他人在用餐时间中的角色和职责，以支持采取协调一致的方法。
