Fengyuan Yang, Shuai Tao, Xiaonan Liu, Zhengjun Zhang
BACKGROUND: Nurses play a central role in day-to-day nutrition care through mealtime support, monitoring and implementation of nutrition strategies, yet the effectiveness of nursing-oriented nutrition interventions across settings remains variably described. This review aimed to determine the effectiveness of nursing nutrition strategies on malnourished patients in clinical and long-term care settings. METHODS: We conducted this review following PRISMA 2020 guidelines. MEDLINE (PubMed), Embase, CINAHL and CENTRAL were searched from database inception to January 2026, supplemented by trial registries and reference screening. Random-effects inverse-variance meta-analyses (DerSimonian-Laird) were performed using standardized mean differences (SMDs) or weighted mean differences (WMDs) and odds ratios (ORs) for mortality. Publication bias was assessed using funnel plots and Egger's regression test. RESULTS: Nursing-oriented nutrition strategies significantly increased energy and protein intake, with substantial heterogeneity. No significant effects were observed for body weight, handgrip strength, ADL or length of hospital stay. Mortality did not differ between groups with low heterogeneity. Publication bias was suggested for intake outcomes but not for weight, length of stay or mortality. CONCLUSION: Nursing-oriented nutrition strategies improve energy and protein intake in malnourished or at-risk patients, but integration with broader multidisciplinary and rehabilitation pathways may be required to influence distal clinical outcomes.