الفهرس 
INTRODUCTION
Multidisciplinary team (MDT) for the NCPOnly 14 pages are availabe for public view
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Abstract
All patients have a right to safe and proper food that fulfills their nutritional needs during hospitalization. Food served to hospital patients should be regarded as an essential part of the patients’ clinical treatment and not just as a hotel service.
Nurses play a fundamental role in providing good nutritional care through ensuring that patients can have their meals in an environment that favors the enjoyment of food.
The aim of the present work was to assess the role of the nurse in the process of providing meals for hospitalized patients in Alexandria.
The study was conducted at five hospitals of different administrative settings in Alexandria namely: University hospital, Ministry of Health hospital, Curative Health Organization hospital, Health Insurance hospital, and private hospital. from each hospital one internal medicine and one surgical ward was randomly selected. The study sample included all nurses (217) working in the previous selected hospital wards.
Two methods of data collection were used in the current study to collect the required data; First: a scheduled interview sheet was used to collect data from the nurses about socio-demographic data, work situation, knowledge of the nurses about hospital patients’ diets, management of hospital food services, nurses’ practices about current nutritional and dietetic services in the hospital, and their opinion about patientsꞌ acceptance of hospital food and receiving external food. Second: an observation sheet was constructed to observe all ward activities related to the patients’ nutritional care. Observations were carried out at the same wards where the researchers were working. It included observation of ward routine related to the provision of breakfast and lunch meals for the patients, observation of the role of the nurse related to providing meals to the patients, and observation of ward environment during meal time.
In the light of data analysis the results could be summarized as follows:
Most of the nurses received their nutrition information from school and hospital work.
Only half of the nurses knew the diagnosis of all the patients in their ward.
Most of the nurses stated that meals were provided to the patients at the same day of their admission.
Most of the nurses stated that therapeutic diets were offered for the patients in the hospital according to their health conditions, and hospital system did not allow the patients to choose any certain type of food.
It was noticed that in most of the studied hospitals there was no separate room in the wards to receive food when it arrives from the kitchen. In all of them meals were assembled in the main kitchen.
The majority of nurses did not give any remarks to the physician while prescribing diet for the patient and about half of them stated that the food supervisor is the one who prepare the food list.
The serving of food for the patients and tray collection was done without any nursing supervision.
The environment in which the patients eat their meals was far from being appetite stimulating in most of the hospitals. Interruption of meal time by doctor rounds or nursing procedures sometimes occurred.
It was noticed in most of the hospitals that disabled patients were fed by their relatives.
Most of the nurses did not match the food the patients received from outside the hospital with the type of diet allowed for them, also if the patient refused his meal or did not eat it they did not care about that.
Most of the nurses did not cooperate with the kitchen staff.
Most of the study nurses stated that the physician provides nutrition education for patients with specific diseases during their stay in hospital and before discharge.
from the findings of the present study the following recommendations are suggested:-
1- The nurse should assume a more active role in diet prescription or at least she should assist the physician through her informative remarks about the patient’s condition.
2- The nurse should participate in the preparation of the food list with the dietitian if available.
3- Nurses’ involvement in the nutritional care process starting from the diet planning till the tray collection should be recognized as an essential part of their job, and each step of the process should be supervised by the head nurse in each ward.
4- Bed side tables should be available for patients to eat their meals on, and a dining room could be established in each ward to allow the ambulatory patients to eat in groups if they want to.
5- On job training program in nutrition is recommended for nurses and other personnel involved in the nutritional care of the patients.
6- Mealtime should have more attention from the ward staff to avoid unnecessary interruptions; also nursing procedures should be rescheduled to be away from patients’ meal time.
7- Nursing staff should be available at the ward during mealtime and should be free from any other duty to monitor patients’ food intake and offer any needed help.
8- Special efforts should be made by the nurse to feed disabled patients.
9- Nurses should ensure that ward environment is quiet, clean and well ventilated in order to improve the patients’ appetite.
10- Special dietary pamphlets should be prepared in simple way to describe what the correct healthy diet is and what the appropriate diet for each health condition is.
11- The nurse could arrange classes for patients under dietary restrictions and those who need special diets using audiovisual materials.
12- Further studies are needed to explore other aspects of the nutritional care not covered in this study such as hospital food hygiene and safety, hospital kitchen sanitation and food preparation facilities, attitude of the patients towards hospital diet, nutritional status of the hospitalized patients.