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

Marples, Owen; Baldwin, Christine; Weekes, C. Elizabeth

doi:10.3945/ajcn.116.144808

Cited by 15 publications

(15 citation statements)

References 54 publications

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“…This is in line with results from a meta-analysis of the evidence of the effect of nutritional knowledge on daily processes and patient outcomes, where it is concluded that it can have severe consequences for the patients when the healthcare professionals’ knowledge or understanding of nutrition are sparse, and it specifically concluded that improvements in the level of knowledge about nutrition had a positive influence on the nutritional related documentation performed by registered nurses. [42]. A significant beneficial effect of increased nutrition knowledge among healthcare workers in nursing homes was found on a range of outcomes, such as increased nutritional intake, improvements in weight and body composition, improvements in reported eating difficulties and finally a significantly lower prevalence of malnutrition in patients [42].…”

Section: Discussionmentioning

confidence: 99%

“…[42]. A significant beneficial effect of increased nutrition knowledge among healthcare workers in nursing homes was found on a range of outcomes, such as increased nutritional intake, improvements in weight and body composition, improvements in reported eating difficulties and finally a significantly lower prevalence of malnutrition in patients [42]. Increased knowledge and understanding about nutrition and documentation can improve nutritional care practice.…”

Section: Discussionmentioning

confidence: 99%

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Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce

Håkonsen

Pedersen

Bygholm

et al. 2019

BMC Health Serv Res

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Background Malnutrition is a comprehensive challenge for the nursing home, home care- and home nursing sector. Nutritional care and the subsequent documentation are a common and multifaceted healthcare practice that requires that the healthcare professionals possess complex combinations of competencies in order to deliver high-quality care and treatment. The purpose of this study was to investigate how a varied group of healthcare professionals’ perceive their own competencies within nutrition and documentation and how organizational structures influence their daily work and the quality of care provided. Methods Two focus groups consisting of 14 healthcare professionals were conducted. The transcribed focus group interviews was analyzed using the qualitative content analysis approach. Results Six categories were identified: 1) Lack of uniform and systematic communication affect nutritional care practices 2) Experience-based knowledge among the primary workforce influences daily clinical decisions, 3) Different attitudes towards nutritional care lead to differences in the quality of care 4) Differences in organizational culture affect quality of care, 5) Lack of clear nutritional care responsibilities affect how daily care is performed and 6) Lack of clinical leadership and priorities makes nutritional care invisible . Conclusions The six categories revealed two explanatory themes: 1) Absent inter- and intra-professional collaboration and communication obstructs optimal clinical decision-making and 2) quality deterioration due to poorly-established nutritional care structure. Overall, the two themes explain that from the healthcare professionals’ point of view, a visible organization that allocates resources as well as prioritizing and articulating the need for daily nutritional care and documentation is a prerequisite for high-quality care and treatment. Furthermore, optimal clinical decision making among the healthcare professionals are compromised by imprecise and unclear language and terminology in the patients’ healthcare records and also a lack of clinical guidelines and standards for collaboration between different healthcare professionals working in nursing homes, home care or home nursing. The findings of this study are beneficial to support organizations within these settings with strategies focusing on increasing nutritional care and documentation competencies among the healthcare professionals. Furthermore, the results advocate for the daily involvement and support of leaders and managers in articulating and structuring the importance of nutritional care and treatment and the subsequent documentation. Electronic supplementary material The online version of this article (10.1186/s12913-019-4450-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce

Håkonsen

Pedersen

Bygholm

et al. 2019

BMC Health Serv Res

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“…It is possible that the observation period was too short to accurately reflect this activity for M2 and M3. In the literature on home care services, many researchers have reported the effects of training on specific objectives [17]. Tourangeau et al [18] have also highlighted the importance of training for providing quality client care.…”

Section: Discussionmentioning

confidence: 99%

A prospective investigation of direct and indirect home care activities in three rural Norwegian municipalities

Helgheim

Sandbaek

Slyngstad

2018

BMC Health Serv Res

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BackgroundHome care providers struggle to manage their day-to-day work, which is increasing in volume and complexity. In general, they are expected to achieve more with the same planning methods, resources, and capacity. To meet emerging needs and use the available resources more effectively and efficiently, evidence and strategies are needed to inform planning methods for home care services. However, limited data are available to inform this change. This paper investigated the amount of time used to carry out direct activities and six indirect activities across three rural Norwegian municipalities (M1, M2 and M3).MethodsHome care staff recorded data over 8 weeks in 2016; the majority of the staff used a smartphone application and some staff used a manual form to report the durations of the activities.ResultsThe median time spent on direct activities was 11–13 min, and this work constituted less than 50% of the total work in the three municipalities. The median driving time was 5–7 min, which accounted for 43–54% of the total indirect work. Administration, particularly reporting and documentation, displayed greater differences across the municipalities, together accounting for 38–50% of the total indirect time. M2 and M3 used substantially more time for documentation, including 20 min in M2 and M3, in contrast to only 1 min in M1. Similarly, the median reporting times were 30 min (M2) and 28 min (M3), compared with only 17 min in M1.ConclusionsHome care staff spent less time on direct activities than on indirect activities, of which several activities have the potential for change. These results may help managers utilize resources effectively and plan appropriately, and they may also serve as a basis for future research to identify areas with improvement opportunities and, in turn, make more time available for direct patient care.

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“…However, systematic review of trials of nutrition training for health care staff conducted by Marples, Baldwin, & Weekes (2017) showed that the use of unvalidated self-administered questionnaires to measure learner and patient outcomes after staff training makes it difficult to draw firm conclusions regarding the results. Thus, this study fills a gap in the literature by providing a validated tool to evaluate the capability of PHC professionals to apply the BDG, internationally recognized by their holistic paradigm of healthy diet (Blake, Durão, Naude, & Bero, 2018;).…”

Section: Discussionmentioning

confidence: 99%

“…, in Brazil, there are findings suggesting a fragmented work process involving nutritionists acting in PHC (Cervato-Mancuso, Tonacio,Silva, & Vieira, 2012;Pedraza & Santos, 2017), although interprofessional collaboration practices are expected.According toKris-Etherton et al (2014), researchers are needed to identify and evaluate new approaches or strategies for educating health care professionals about nutrition and healthy lifestyle behaviors and how interprofessional nutrition education with multidisciplinary teamwork contributes to more coordinated and qualified care.Training for health care staff is recognizably able to produce positive effects on professionals' practice and attitudes(Berggren et al, 2015;Marples et al, 2017;Torres, Amaral, Amorim, Cyrino, & Bodstein, 2010). ForGotwals (2018), effective nutritional health promotion interventions are those that lead to an increased perceived self-efficacy in knowledge and ability to counsel.…”

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confidence: 99%

Tecnologias de apoio à implementação do guia alimentar para a população brasileira na atenção básica

Reis¹

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Introduction: The dissemination of dietary guidelines is globally seen as crucial for the healthy eating promotion policies, especially those targeting the training of facilitators. Objective: To develop and validate technologies to support the implementation of the Brazilian Dietary Guidelines (BDG) in Primary Health Care (PHC). Methodology: Three manuscripts about development and validation of measurement tools were written. Manuscript 1-GAB1 (scale for measuring the knowledge of PHC professionals about the BDG) was developed and validated in six steps: items' development, content validation with panel of experts, face validation with potential users, online reevaluation by health professionals and experts, online application with PHC professionals working all over Brazil's macro-regions, confirmatory factor analysis to investigate construct validity. Manuscript 2-GAB2 (scale for measuring the self-efficacy and collective efficacy of PHC professionals to apply the BDG) were submitted to the same procedures described in manuscript 1. Manuscript 3-GAB3 (scale for evaluating the implementation of the BDG in PHC educational interventions) was developed, validated and tested in five steps: items' development; content validation with panel of experts; face validation with potential users; online reevaluation; test-retest to analyze intra and interobserver agreement and reliability with experts applying GAB3 while watching 4 videos produced for this study. Results: Manuscript 1-GAB1 was initially developed with 25 items and it was reduced to 22 items after content and face validation. GAB1's items were considered clear and representative of the BDG, with exception of 1 item that was excluded when the scale was reevaluated. This version of the scale was applied to 209 PHC professionals through a website. In the confirmatory factor analysis, GAB1's initial model constituted by 21 items had 5 items excluded: 4 returned bivariate empty cells and 1 with lowest discrimination value. All the fit indices returned a well-fitted model constituted by 16 items loaded onto 1 dimension, with peak of information centered below the mean. Manuscript 2-GAB2 was initially developed with 22 items and it reached 24 items equally divided in part A (self-efficacy) and B (collective efficacy) after content and face validation. All GAB2's items were considered clear and representative of the BDG when reevaluated. GAB2 showed to have excellent fit indices, with peak of information centered around the mean. Manuscript 3-GAB3's items were reduced from 72 to 25 after content validation. The scale reached 17 items in the face validation accompanied by a completion manual, reviewed by specialists. All the 17 items were considered clear and representative of the BDG when reevaluated and adjustments in the manual's content were made. Thirty raters applied GAB3 to watch the videos for test and 28 for the retest. All videos obtained combined kappa values>0.4. In the test-retest, only one rater had an agreement <0.4 and for reliability, only two raters ...

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

Cited by 15 publications

References 54 publications

Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce

Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce

A prospective investigation of direct and indirect home care activities in three rural Norwegian municipalities

Tecnologias de apoio à implementação do guia alimentar para a população brasileira na atenção básica

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