A National Survey on the Implementation Status and Current Quality Monitoring Practices of Nutrition Nursing Clinics in China

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AIM: This national, cross-sectional survey aimed to describe the current implementation status of Nutrition Nursing Clinics (NNCs) in China and to map the landscape of quality monitoring indicators in use, thereby establishing a foundational evidence base for future service optimisation and the development of standardised evaluation tools. DESIGN: A nationwide cross-sectional survey. METHODS: Conducted from August to October 2024, the study involved 164 randomly sampled public hospitals. Data were collected via a validated 32-item questionnaire, developed through a systematic process of literature review, expert consultation (n = 10) and pilot testing. The questionnaire was structured into four domains: (I) General Hospital Demographics, (II) Current Operational Status of the Nutrition Clinic, (III) Current Use of Quality Monitoring Indicators (categorised by the Donabedian Structure-Process-Outcome Framework) and (IV) Recommendations for NNC Development. Descriptive statistics were employed for data analysis. RESULTS: The valid response rate was 68.9% (113/164). Key findings across the four survey domains were: (1) Establishment and Basic Profile: Among the respondents, 37 hospitals (32.7%) had established NNCs, with 75.7% initiated within the past 5 years. (2) Operational Characteristics: NNCs were predominantly in tertiary hospitals (70.3%), operated 1-3 days per week (78.4%) and were mostly managed by nursing departments (70.3%). Daily patient volume was typically ≤ 15 (75.6%). (3) Quality Monitoring Landscape: A pooled inventory of 66 distinct monitoring indicators was identified, revealing significant heterogeneity in practice. Monitoring focused on structural elements (e.g., personnel qualifications) and initial processes (e.g., assessment), with less emphasis on care continuity, interdisciplinary collaboration and patient-reported outcomes. (4) Challenges and Suggestions: The reported challenges primarily focused on systemic and operational barriers. The most prominent issues included the absence of billing items for nutrition techniques (67.6%) and insufficient insurance coverage (59.5%). Additional challenges included limited prescription authority for nurses and practical difficulties in follow-up management. Furthermore, participating hospitals proposed specific suggestions for development, such as enhancing feasibility through strengthened publicity and interdepartmental collaboration, as well as ensuring financial sustainability to support operations by establishing upstream and downstream cooperative relationships with other clinical departments. CONCLUSION: This study provides the first national profile of NNC implementation in China. The findings reveal a field characterised by a low establishment rate, concentrated service delivery and a complete absence of standardised quality monitoring. A core contribution of this work is the systematic survey and compilation of a descriptive inventory of 66 quality monitoring indicators currently in use, which we categorised and analysed according to the Donabedian framework. This inventory reflects the highly heterogeneous and uncoordinated nature of current evaluation practices. This study provides the necessary foundation to inform the future development of a standardised, contextually relevant quality evaluation framework for NNCs. NO PATIENT OR PUBLIC CONTRIBUTION: This study analysed anonymised institutional data. No direct patient or public involvement occurred.

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