Aim: This systematic review examined studies for improvement in energy and protein intake, nutritional status, and clinical outcomes when specific nutritional models-of-care (protected mealtimes, feeding assistance, communal dining and the red tray initiative) were implemented in hospitalised acute and rehabilitation patients. Methods: An electronic database search was conducted on MEDLINE, Embase and CINAHL. Reference lists were also hand searched, and a key author search was completed. Two reviewers independently applied selection criteria and assessed trial quality. Results: A total of 172 articles were identified from the search strategy, and after application of inclusion and exclusion criteria, seven articles were included for final review. Most studies found a mean improvement in energy and protein intake from the implementation of the feeding assistance and communal dining models, although the overall quality of the evidence is low. No studies found a significant difference in weight, and the two trials measuring key clinical outcomes found no differences in length of stay and most markers of nutritional status; results for mortality were mixed. Protected mealtimes had a negative effect on energy and protein intake, although only one study was included for review; and no studies were found looking at the red tray initiative. Conclusions: While some of the evidence appears positive, this review highlights that there is a scarcity of high-quality evidence to support the use of specific nutritional models-of-care to improve energy and protein intake in hospitalised patients. Large-scale multicentre trials focusing more on primary outcomes of clinical relevance are still required.
The future of hospital social work departments depends on their ability to demonstrate their effectiveness, efficiency, and consequently, their value to their host organizations. In order to demonstrate and enhance social work's contribution, research activities of various kinds must be encouraged. These include research consumption as well as production and utilization by clinicians, supervisors, managers, and administrators. The authors sought to develop a sustainable research environment in a large social work department of an academic health system. Continued work is needed to understand practice-research "best practices" within hospitals and how to ensure their sustainability within an ever changing health care environment.
Women with newly diagnosed vulvodynia report substantial impact of vulvar pain but feel little control over symptoms. Sexual desire and sexual satisfaction are low. Most of the respondents would consider counseling to help address these issues.
There is ample literature describing the ongoing stressors and tremendous emotional impact on health care professionals caring for patients with AIDS. This paper is a report of a research study which explored collegial relationships and staff retention to determine factors that reduced staff burnout. The study explored an observed phenomenon of pairing among staff members of various disciplines, working with patients with AIDS, in a tertiary care hospital. The authors called this phenomenon "survival bonding." These informal but intense relationships offered staff a mutually supportive environment which reduced their anxiety, stress, and helped prevent burnout. Given the growing volume of HIV infected persons, and the increased work load of many health care professionals in the aids field, it is important to understand the complex emotional and social support needs of staff to prevent burnout and to improve staff recruitment and retention.
Practice-based evaluation integrates research skills and techniques into the clinical process in order to correlate clinical interventions with treatment outcomes. Although most clinicians recognize the importance of some form of practice evaluation, barriers including lack of time, resources, expertise, and organizational support may deter such evaluation efforts. However, there are numerous advantages for clinicians and agencies to develop a culture that values and integrates practice evaluation into its daily work-life; these include opportunities for teamwork, collaboration, mentoring, and innovation. This paper defines practice evaluation research, identifies strategies for its implementation, and describes a framework for creating a "research friendly" culture. It further describes the implementation of such an innovative program in both a hospital and a mental health agency setting.
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