Cargando…

Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study

Hospital-acquired malnutrition is a significant issue with complex aetiology, hence nutrition interventions must be multifaceted and context-specific. This paper describes the development, implementation and process evaluation of a complex intervention for improving nutrition among medical patients...

Descripción completa

Detalles Bibliográficos
Autores principales: Roberts, Shelley, Grealish, Laurie, Williams, Lauren T., Hopper, Zane, Jenkins, Julie, Spencer, Alan, Marshall, Andrea P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628331/
https://www.ncbi.nlm.nih.gov/pubmed/31238528
http://dx.doi.org/10.3390/healthcare7020079
_version_ 1783434935601725440
author Roberts, Shelley
Grealish, Laurie
Williams, Lauren T.
Hopper, Zane
Jenkins, Julie
Spencer, Alan
Marshall, Andrea P.
author_facet Roberts, Shelley
Grealish, Laurie
Williams, Lauren T.
Hopper, Zane
Jenkins, Julie
Spencer, Alan
Marshall, Andrea P.
author_sort Roberts, Shelley
collection PubMed
description Hospital-acquired malnutrition is a significant issue with complex aetiology, hence nutrition interventions must be multifaceted and context-specific. This paper describes the development, implementation and process evaluation of a complex intervention for improving nutrition among medical patients in an Australian hospital. An integrated knowledge translation (iKT) approach was used for intervention development, informed by previous research. Intervention strategies targeted patients (via a nutrition intake monitoring system); staff (discipline-specific training targeting identified barriers); and the organisation (foodservice system changes). A process evaluation was conducted parallel to implementation assessing reach, dose, fidelity and staff responses to the intervention using a mixed-methods design (quantitative and qualitative approaches). Staff-level interventions had high fidelity and broad reach (61% nurses, 93% foodservice staff and all medical staff received training). Patient and organisation interventions were implemented effectively, but due to staffing issues, only reached around 60% of patients. Staff found all intervention strategies acceptable with benefits to practice. This study found an iKT approach useful for designing a nutrition intervention that was context-specific, feasible and acceptable to staff. This was likely due to engagement of multiple disciplines, identifying and targeting specific areas in need of improvement, and giving staff frequent opportunities to contribute to intervention development/implementation.
format Online
Article
Text
id pubmed-6628331
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-66283312019-07-23 Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study Roberts, Shelley Grealish, Laurie Williams, Lauren T. Hopper, Zane Jenkins, Julie Spencer, Alan Marshall, Andrea P. Healthcare (Basel) Article Hospital-acquired malnutrition is a significant issue with complex aetiology, hence nutrition interventions must be multifaceted and context-specific. This paper describes the development, implementation and process evaluation of a complex intervention for improving nutrition among medical patients in an Australian hospital. An integrated knowledge translation (iKT) approach was used for intervention development, informed by previous research. Intervention strategies targeted patients (via a nutrition intake monitoring system); staff (discipline-specific training targeting identified barriers); and the organisation (foodservice system changes). A process evaluation was conducted parallel to implementation assessing reach, dose, fidelity and staff responses to the intervention using a mixed-methods design (quantitative and qualitative approaches). Staff-level interventions had high fidelity and broad reach (61% nurses, 93% foodservice staff and all medical staff received training). Patient and organisation interventions were implemented effectively, but due to staffing issues, only reached around 60% of patients. Staff found all intervention strategies acceptable with benefits to practice. This study found an iKT approach useful for designing a nutrition intervention that was context-specific, feasible and acceptable to staff. This was likely due to engagement of multiple disciplines, identifying and targeting specific areas in need of improvement, and giving staff frequent opportunities to contribute to intervention development/implementation. MDPI 2019-06-24 /pmc/articles/PMC6628331/ /pubmed/31238528 http://dx.doi.org/10.3390/healthcare7020079 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Roberts, Shelley
Grealish, Laurie
Williams, Lauren T.
Hopper, Zane
Jenkins, Julie
Spencer, Alan
Marshall, Andrea P.
Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study
title Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study
title_full Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study
title_fullStr Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study
title_full_unstemmed Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study
title_short Development and Process Evaluation of a Complex Intervention for Improving Nutrition among Hospitalised Patients: A Mixed Methods Study
title_sort development and process evaluation of a complex intervention for improving nutrition among hospitalised patients: a mixed methods study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628331/
https://www.ncbi.nlm.nih.gov/pubmed/31238528
http://dx.doi.org/10.3390/healthcare7020079
work_keys_str_mv AT robertsshelley developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy
AT grealishlaurie developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy
AT williamslaurent developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy
AT hopperzane developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy
AT jenkinsjulie developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy
AT spenceralan developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy
AT marshallandreap developmentandprocessevaluationofacomplexinterventionforimprovingnutritionamonghospitalisedpatientsamixedmethodsstudy