Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
From Nurse-Led to Clinical Dietitian-Led Nutritional Care in Hospital Practice: Changes in Nutritional Risk Screening Rates, Patient Nutritional Intake and Professional Perspectives.
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Kristensen Marianne Boll, Rask Ingeborg Krarup, Schmidt Lene Nissen Møller, Frederiksen Kirstine Guld, Erichsen Alexander, Viggers Lone
Аннотация
INTRODUCTION: Daily nutritional care is often nurse-led, with clinical dietitians involved only upon referral. This study explored the effects of integrating clinical dietitians into daily nutritional care through reallocation of nutritional care tasks at a medical pulmonary ward, focusing on nutritional risk screening practices, patient nutritional intake, and professional perspectives.
METHODS: This multimethod study included three substudies: (1) a retrospective cohort analysis of nutritional risk screening practices, (2) a quasi-experimental comparison of nutritional intake between a historical control group and the intervention group, and (3) qualitative interviews with nurses and clinical dietitians following completion of the intervention.
RESULTS: In substudy 1, 1678 admissions were analysed. During clinical dietitian-led nutritional care, 55% of patients were screened within 24 h of admission and 76% overall, compared to 29% and 43% during nurse-led care. In substudy 2, a greater proportion of patients in the intervention group achieved ≥ 75% of their energy requirements than in the control group (79% vs. 57%, p = 0.023), whereas differences in protein intake were not statistically significant (50% vs. 35%). In substudy 3, both professions reported improved nutritional care and collaboration. Nurses described relief but reduced awareness of patients' nutrition, while clinical dietitians found the new tasks meaningful but challenging. Coordination and dialogue were important in adapting to changed routines.
CONCLUSION: Reallocating nutritional care tasks from nurses to clinical dietitians was associated with improved nutritional risk screening, higher energy coverage, and stronger interdisciplinary collaboration, particularly when supported by close coordination and dialogue between clinical dietitians and nursing staff.
METHODS: This multimethod study included three substudies: (1) a retrospective cohort analysis of nutritional risk screening practices, (2) a quasi-experimental comparison of nutritional intake between a historical control group and the intervention group, and (3) qualitative interviews with nurses and clinical dietitians following completion of the intervention.
RESULTS: In substudy 1, 1678 admissions were analysed. During clinical dietitian-led nutritional care, 55% of patients were screened within 24 h of admission and 76% overall, compared to 29% and 43% during nurse-led care. In substudy 2, a greater proportion of patients in the intervention group achieved ≥ 75% of their energy requirements than in the control group (79% vs. 57%, p = 0.023), whereas differences in protein intake were not statistically significant (50% vs. 35%). In substudy 3, both professions reported improved nutritional care and collaboration. Nurses described relief but reduced awareness of patients' nutrition, while clinical dietitians found the new tasks meaningful but challenging. Coordination and dialogue were important in adapting to changed routines.
CONCLUSION: Reallocating nutritional care tasks from nurses to clinical dietitians was associated with improved nutritional risk screening, higher energy coverage, and stronger interdisciplinary collaboration, particularly when supported by close coordination and dialogue between clinical dietitians and nursing staff.