Date of Award

2011-05-01

Degree Name

PhD Nursing

Dissertation Committee

Dr. Ann M. Mayo, Chairperson; Dr. Cynthia D. Connelly; Dr. Patricia A. Roth

Keywords

clinical outcomes, elderly, Gerontology, malnutrition, nursing, nursing home, nutritional status, Pressure ulcers

Abstract

Purpose The purpose of this research study was to describe the nutritional status (well nourished, at risk for malnutrition, or malnourished) of residents admitted to nursing homes and adverse clinical outcomes in those residents after four weeks. Methodology A descriptive, correlational design utilizing medical record data was used to examine the relationship between nutritional status and adverse clinical outcomes of weight loss and pressure ulcers. Results The sample (n=69) was predominately Caucasian (90%) with 38% having one or more pressure ulcers on admission. Most of the residents were admitted from an acute care facility (97%) and were either malnourished or at risk for malnutrition at the time of admission to a nursing home. At admission, there was no significant difference between the three groups of nutritional status (well nourished, at risk for malnutrition, and malnourished) in terms of pressure ulcers (F=1.127, p=0.33-). Just over half (52%) of the individuals remained at the nursing home at four weeks and of those 54% experienced a significant weight loss of 5% or more and 33% had one or more pressure ulcers. At four weeks, there were no significant differences between the three groups of nutritional status on the adverse clinical outcomes of weight loss (x²=3.37, df=2, p=0.185) or pressure ulcers (F=1.600, -=0.216). However, the relationship between nutritional status at admission and pressure ulcers at four weeks was significant (gamma value = 0.649; p = 0.016). Conclusion Older adults admitted to nursing homes were either at risk for malnutrition or are malnourished. Older adults experience a significant unintentional weight loss of 5% or more at four weeks following admission to a nursing home that was not related to nutritional status at admission. There was a relationship between nutritional status at admission and the presence of pressure ulcers at four weeks with those with poorer nutrition being more inclined to develop pressure ulcers. Nurses caring for older adults in nursing homes need to initiate weight monitoring processes early after an individual has been admitted to mitigate the tendency of older adults to lose weight and develop pressure ulcers following admission to a nursing home.

Document Type

Dissertation: Open Access

Department

Nursing

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Included in

Nursing Commons

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