BackgroundNutritional care is a basic human right for all people. Nevertheless, undernourishment is known to be a frequent and serious health care problem among elderly hospitalized patients in Western Europe. Nutritional documentation contributes to ensuring proper nutritional treatment and care. Only a few studies have explored how nurses document nutritional care in hospitals, and between hospitals and nursing homes. Available research suggests that documentation practices are unsatisfactory. The aim of this study was to explore how nurses document nutritional treatment and care for elderly patients in hospitals and how nurses and undergraduate nurses communicate information about patients’ nutritional status when elderly patients are transferred between hospital and nursing homes.MethodsA qualitative study was conducted using a phenomenological-hermeneutic approach. Data was collected in focus group interviews with 16 nurses in one large university hospital, and 11 nurses and 16 undergraduate nurses in five nursing homes associated with the university hospital. Participants from the university hospital represented a total of seven surgical and medical wards, all of which transferred patients to the associated nursing homes. The catchment area of the hospital and the nursing homes represented approximately 10% of the Norwegian population in heterogenic urban and rural municipalities. Data were coded and analysed thematically within the three contexts: self-understanding, critical common sense, and theoretical understanding.ResultsThe results were summarized under three main themes 1) inadequate documentation of nutritional status on hospital admission, 2) inadequate and unsystematic documentation of nutritional information during hospital stay, 3) limited communication of nutritional information between hospital and nursing homes. The three main themes included seven sub-themes, which reflected the lack of nutritional screening and unsystematic documentation on admission and during hospital stay. Further the sub-themes elucidated poor exchange of information between hospital and nursing homes regarding the nutritional status of patients.ConclusionOverall, the documentation of nutritional treatment and care for elderly patients was inadequate in the hospital and between health care settings. Inappropriate documentation can create a negative nutritional spiral that leads to increased risk of severe health related complications for elderly patients. Moreover, it hinders nutritional follow-up across health care settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-016-0193-z) contains supplementary material, which is available to authorized users.

There is a lack of accurate prevalence data on undernutrition and the risk of undernutrition among the hospitalised elderly in Europe and Norway. We aimed at estimating the prevalence of nutritional risk by using stratified sampling along with adequate power calculations. A cross-sectional study was carried out in the period 2011 to 2013 at a university hospital in Norway. Second-year nursing students in acute care clinical studies in twenty hospital wards screened non-demented elderly patients for nutritional risk, by employing the Nutritional Risk Screening 2002 (NRS2002) form. In total, 508 patients (48·8 % women and 51·2 % men) with a mean age of 79·6 (sd 6·4) years were screened by the students. Mean BMI was 24·9 (sd 4·9) kg/m2, and the patients had been hospitalised for on average 5·3 (sd 6·3) d. WHO's BMI cut-off values identified 6·5 % as underweight, 48·0 % of normal weight and 45·5 % as overweight. Patients nutritionally at risk had been in hospital longer and had lower average weight and BMI compared with those not at risk (all P < 0·001); no differences in mean age or sex were observed. The prevalence of nutritional risk was estimated to be 45·4 (95 % CI 41·7 %, 49·0) %, ranging between 20·0 and 65·0 % on different hospital wards. The present results show that the prevalence of nutritional risk among elderly patients without dementia is high, suggesting that a large proportion of the hospitalised elderly are in need of nutritional treatment.