Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel

Keller, Heather; Vesnaver, Elisabeth; Davidson, Bridget; Allard, Johane P.; Laporte, Manon; Bernier, Paule; Payette, Hélène; Jeejeebhoy, Khursheed N.; Duerksen, Donald R.; Gramlich, Leah

doi:10.1111/jhn.12170

Cited by 61 publications

(108 citation statements)

References 30 publications

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“…A systematic best practice pathway, such as INPAC, is needed to help identify those patients that might need additional nutrition intervention and ensure dietitians are seeing the patients most in need of their specialized services [9]. Research has shown that hospital staff recognize the need to create effective systems to ensure quality nutrition care, yet it is challenging to put this into regular practice [37,38].…”

Section: Discussionmentioning

confidence: 99%

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Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

et al. 2017

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Background: Malnutrition is common in hospitalized patients and is associated with increased mortality, length of stay, and risk of re-admission. The consensus based Integrated Nutrition Pathway for Acute Care (INPAC) was developed and validated to enhance patients' nutrition care and improve clinical outcomes. As part of the More-2-Eat project (M2E), five hospitals implemented INPAC activities (e.g. screening) in a single medical unit. The purpose of this paper is to demonstrate the care gaps with respect to INPAC activities on these five units prior to implementation. Results were used as part of a needs assessment on each unit, demonstrating where nutrition care could be improved and tailoring of implementation was required.

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Section: Discussionmentioning

confidence: 99%

“…Keller et al discovered that many nutrition care practices in Canadian hospitals (including diagnosis, treatment and monitoring) were haphazard [9]. This suggests a need for multi-faceted, systematic approaches to nutrition care and malnutrition management [4,9,25,27,28].…”

Section: Introductionmentioning

confidence: 99%

Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

et al. 2017

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“…Because of high staff turnover, repeated training sessions may be required to contribute to improved nutritional care (27,36). In practice, nutrition training may also need to be implemented alongside clinical processes, such as routine nutrition screening, to support the management of malnutrition on a systematic level (50,52,53).…”

Section: Discussionmentioning

confidence: 99%

The effect of nutrition training for health care staff on learner and patient outcomes in adults: a systematic review and meta-analysis

Marples

Baldwin

Weekes

2017

The American Journal of Clinical Nutrition

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Background: Nutrition training for health care staff has been prioritized internationally as a key means of tackling malnutrition; however, there is a lack of clear evidence to support its implementation. Systematic reviews in other fields of training for health care staff indicate that training strategies may have a beneficial impact on learner and patient outcomes. Objectives: We assessed whether nutrition training for health care staff caring for nutritionally vulnerable adults resulted in improved learner and patient outcomes and evaluated the effectiveness of different training strategies. Design: A systematic review of trials of nutrition training for health care staff was conducted. Six databases were searched with key terms relating to malnutrition and nutrition training. Studies were categorized according to cognitive (didactic teaching), behavioral (practical implementation of skills), and psychological (individualized or group feedback and reflection) training strategies. Where sufficient data were available, meta-analysis was performed according to study design and training strategy. All study designs were eligible. The risk of bias was evaluated in accordance with Cochrane guidance. Results: Twenty-four studies met the eligibility criteria: 1 randomized controlled trial, 4 nonrandomized controlled trials, 3 quasiexperimental trials, 13 longitudinal pre-post trials, 2 qualitative studies, and 1 cross-sectional survey. Results from a number of low-quality studies suggest that nutrition training for health care staff may have a beneficial effect on staff nutrition knowledge, practice, and attitude as well as patient nutritional intake. There were insufficient data to determine whether any particular training strategy was more effective than the others. Conclusions: In the absence of high-quality evidence, low-quality studies suggest that nutrition training for health care staff has some positive effects. However, further randomized controlled trials are required to confirm overall efficacy and to explore the impact of training strategies on learner and patient outcomes.Am J Clin Nutr 2017;106:284-310.

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“…director of care, lead nurse, physician, clinical nutrition manager, chief executive office of the hospital) as part of the site proposal process [48,50,[58][59][60][61]. Three of the five sites had participated in the Nutrition Care in Canadian Hospitals (NCCH) study, which was a prevalence investigation focused on describing the issues of malnutrition, outcomes and care practices in hospitals [3,7,17]. This initial NCCH study led to a program of research, which resulted in the development of INPAC and now, M2E.…”

Section: Overview Of the More-2-eat Projectmentioning

confidence: 99%

“…Identifying notable gaps in the care system will drive the identification of potential solutions to improve these outcomes. For example, dietitian consults are typically haphazard [6,17] and standardized nutrition screening programs could ensure that malnourished patients are identified and treated. Patients report many barriers to food intake [18] and effective low-technology solutions could be a feasible way to address these issues.…”

Section: Introductionmentioning

confidence: 99%

More-2-Eat: evaluation protocol of a multi-site implementation of the Integrated Nutrition Pathway for Acute Care

et al. 2017

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Background: Nutrition care in hospitals is often haphazard, and malnourished patients are not always readily identified and do not receive the care they require. The Integrated Nutrition Pathway for Acute Care (INPAC) is an algorithm designed to improve the prevention, detection and treatment of malnutrition in medical and surgical patients. More-2-Eat is an evaluation of the implementation of INPAC care activities (e.g. screening) in five diverse medical units from different hospitals in Canada. The primary purpose is to understand how tailored implementation affects INPAC uptake and factors that impact this implementation. The principal outcome is a toolkit that can provide guidance to others.

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Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel

Abstract: The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed.

Cited by 61 publications

References 30 publications

Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

The effect of nutrition training for health care staff on learner and patient outcomes in adults: a systematic review and meta-analysis

More-2-Eat: evaluation protocol of a multi-site implementation of the Integrated Nutrition Pathway for Acute Care

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