Malnutrition can be defined as a serious condition that occurs when a person does not include the right amount of nutrients in their diet such as water, protein, fats, carbohydrates, vitamins and minerals in their diet (NICE, 2012). This can lead to serious adverse circumstances where one can become malnourished. Kirch (2008) also stresses that malnutrition can also arise as a result of disease. The rational for the chosen topic ‘malnutrition in elderly patients, was based on being one of the largest contributors to elderly mortality in health care. In support Sinclain (2011) states that up to 15% of elderly in the community, 62% of hospitalised patients and 85% of nursing home residents suffer from malnutrition which is a strong independent predictor of mortality in elderly. Evidence based practice in nursing is finding solid research and applying them in nursing practices, in order to promote quality of care given to patient’s. Furthermore Baker (2013) states that it is a process which involves the use of evaluation, research process, problem solving, assessment of care, decision making and requires the patients involvement.
Evidence based practice is important in clinical settings having the potential to improve the of care patient, implemented to improve recovery. The nursing and midwifery council (NMC 2008) recommended that all nurses must have the ability to critique and use evidence based practice. Developing a framework for critiquing health research (Caldwell et al, 2005) will be used as an appraisal method to critique the 3 empirical research articles. This was chosen by the writer because the authors made it clear, straightforward, easy and precise to use in critiquing academic research papers, both qualitative and quantitative using tables, numbers, keywords subheadings, guidelines and relevant websites. It was also discussed that this assists the ‘novice’ nursing student and health-related research with learning about the two approaches to research by giving consideration to aspects of the research process that are common to both methodologies approach and different stages of critiquing them.
Boud et al (1985) articulate reflection as a act in which an individual examines their experiences, beliefs, values behaviour and knowledge that leads to a new understanding and appreciation of a situation which prompted the reflective process. Yun, (2008) emphasise reflection is an active and intentional process that uses thinking in order to learn from experience. We reflect in order to learn from current or future experiences aiding us in improving academic skills in theory and in practical, the ethics of reflection contain information such as asking questions or reflecting on what actually happened, looking at the skills that were used to deal with the situation, examine the negative and positives looking into what feelings arose from the experiences, what could have be done and what can be done better in the future.
As nurses we need to reflect on our own practice to enhance the care given to patients. Rolfe et al model (2001) Cycle has been chosen to support writer reflection and this was chosen because it is a simple model which raises the following questions what, so what and now what in order to reflect effectively and improve the quality of care given to patients stimulating both personal and professional growth. In nursing practice we need to plan and leave time in order to reflect on the care delivered to patients. Following this we need to reveal the service given has confidentiality, privacy and dignity and this is being maintained, check if the patient treated is being fairly and with respect, if the nurses communicate with the patients in ways they understand. All these collective questions need to be in place when caring for patients in order to support reflection and deliver a good standard of care. Elder, Evans and Nizette (2012) states reflection allows nurses to examine both their practice and the accompanying cognitions and effective meanings in relation to values, biases and knowledge and in relation to the context in which the situation occurred.