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Using clinical quality databases to monitor the quality of fundamental care: Example with weight status after severe traumatic brain injury

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  • Lene Odgaard
  • Lena Aadal
  • Marianne Eskildsen
  • Ingrid Poulsen

Abstract

Aims and objectives To determine weight status and risk of overweight up to 1 year after severe traumatic brain injury (TBI) as basis for defining nursing‐sensitive indicators of fundamental nutritional nursing care in a clinical quality database. Background Patients' nutritional needs are recognised as fundamental care during hospitalisation, but less attention has been given to nutritional status after discharge. Design Nationwide cohort study. The STROBE checklist was used to ensure reporting quality. Methods Data were retrieved from the Danish Head Trauma Database, a clinical quality database aiming at improving the quality of neurorehabilitation. Individuals aged ≥ 15 years with severe TBI 2011–2015 (N = 424) were included. Normal weight, underweight and overweight were described according to the body mass index (BMI) at admission to subacute rehabilitation, at discharge and at 1 year postinjury. The probability of transition between weight groups from admission to 1 year postinjury was calculated. Multivariable binominal regression analyses compared risk of overweight between age groups. Results The prevalence of underweight decreased from 13% at admission to 6% and 3% at discharge and 1 year postinjury, respectively. The prevalence of overweight was stable at 26%–27% at admission and discharge and increased to 44% at 1 year postinjury. Of the individuals not overweight at admission, 28% became overweight by 1 year postinjury. Overweight was significantly more prevalent in older compared to younger individuals. The risk of becoming overweight among those not overweight at admission did not differ between age groups. Conclusion Underweight individuals achieved normal weight during inpatient rehabilitation. By 1 year postinjury, individuals were increasingly overweight. Relevance to clinical practice Weight status has potential as nursing‐sensitive indicators that may be included in clinical quality databases to inform the organisational and policy level on the state of fundamental nutritional nursing care. The inclusion emphasise requested responsibilities of nursing care. This facilitates health economic attention and influences nursing professional execution.

Suggested Citation

  • Lene Odgaard & Lena Aadal & Marianne Eskildsen & Ingrid Poulsen, 2020. "Using clinical quality databases to monitor the quality of fundamental care: Example with weight status after severe traumatic brain injury," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(11-12), pages 2031-2038, June.
  • Handle: RePEc:wly:jocnur:v:29:y:2020:i:11-12:p:2031-2038
    DOI: 10.1111/jocn.15233
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    References listed on IDEAS

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    1. David A. Richards & Angelique Hilli & Claire Pentecost & Victoria A. Goodwin & Julia Frost, 2018. "Fundamental nursing care: A systematic review of the evidence on the effect of nursing care interventions for nutrition, elimination, mobility and hygiene," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(11-12), pages 2179-2188, June.
    2. Malene Beck & Bente Martinsen & Ingrid Poulsen & Regner Birkelund, 2016. "Mealtimes in a neurological ward: a phenomenological‐hermeneutic study," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(11-12), pages 1614-1623, June.
    3. Diana Jefferies & Maree Johnson & Jennifer Ravens, 2011. "Nurturing and nourishing: the nurses’ role in nutritional care," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(3‐4), pages 317-330, February.
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    1. Alvisa Palese & Jessica Longhini & Matteo Danielis, 2021. "To what extent Unfinished Nursing Care tools coincide with the discrete elements of The Fundamentals of Care Framework? A comparative analysis based on a systematic review," Journal of Clinical Nursing, John Wiley & Sons, vol. 30(1-2), pages 239-265, January.

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