Implementing a best practice statement in nutrition for frail older people: part 1

In the first of two articles, the authors describe stages in the development and testing of a ‘best practice statement’ designed to improve nutrition in physically frail older people.

Innovation and developments in practice can be traced throughout the history of gerontological nursing, despite the challenges arising from its legacy of under-resourcing, poor staffing and lack of recognition (McCormack 2001). Many major changes for nursing have been initiated within centres of gerontological nursing excellence. But leaders may have assumed that publishing descriptions of positive advances in practice will enthuse and enable practitioners to replicate the developments within their own areas. Such a model is reliant on the commitment of individuals and can result in ad hoc, unpredictable practice development that may be difficult to sustain (Eve 2004). If a true difference to more than a minority of potential beneficiaries is to be made, the greatest challenge to gerontological nursing lies in the development, acceptance and implementation of a systematic model for the development of practice. In Scotland, a national practice development project (Gerontological Nursing Demonstration Project) has been running since 2001, involving over 80 practising nurses, with the purpose of developing and demonstrating such a model for the systematic improvement in quality of care provision to older people.