Exploring the nutrition nursing’s care surrounding terminally ill patient. A scoping review

      Background: Eating and drinking have a deep symbolism in all societies because they are necessary to sustain life [Bryon, 2008]. They are among the most fundamental physiological human needs [Maslow 1943, Henderson, 1958]. Many patients with long-term conditions experience symptoms that reduce appetite, impair nutrient utilization and restrict their ability to obtain, consume and enjoy food. For them eat and drink is very difficult to do, while for healthcare providers is pivotal to restore and maintain a good state of nutrition and hydration through different interventions [Holmes, 2010]. The use of artificial nutrition and hydration for terminally ill is made possible through diverse site such as enteral or parenteral. Define the nutritional care planning is a healthcare professionals’ responsibility. Physicians are considered th primary responsible for decision-making and for prescription of initiating artificial food or fluid; nurses are usually the main responsible to provide nutritional care essentially through practical activities but that they are no integrated in a deeper way
      Aim: To find the nursing involvement in artificial nutrition and hydration of palliative care and understand what are their competences and professionals’ provisions on it.
      Method: The Arksey and O’Malley five steps approach of scoping review revised by Levac and colleagues. The research was conducted in Italy with an evaluation of the literature in an international perspective, to not exclude the different perspectives of this phenomenon Three nursing students and two experts nursing professors in palliative and hospice care, formed the research team. After this the meaning was mapped by creating the main categories.
      Results: Twenty-five articles were identified by database searching, five by screening reference lists and five directly by the journals. The main categories found were related to: ethics, decision making, clinical aspects and education where nurses act in conjunction with other health professionals.
      Conclusion: Still confusion and not great clarity exists on nutrition and hydration in palliative care. Nurses have a great importance in such fragile context. It is demonstrated not just relying on their practical activities or clinical skills but also from their role and position in the planning and support to the decision-making process of the artificial nutrition and hydration process.