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Heitman K, Proaño GV, Papoutsakis C, Diaque Ballesteros P, Steiber A, Taylor CA. Learning Outcomes From a Virtual Nutrition Care Process Workshop Delivered to Nutrition and Dietetics Professionals in Mexico. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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2
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Sheffer Hilel G, Drach-Zahavy A, Endevelt R. The paradoxical effects of professional stereotypes on the quality of care by interprofessional teams: The contingent effects of team faultlines, team stereotypes, and championship behaviors. Front Psychol 2023; 14:1135071. [PMID: 36998356 PMCID: PMC10043446 DOI: 10.3389/fpsyg.2023.1135071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundDespite calls for interprofessional teamwork to ensure quality care in healthcare settings, interprofessional teams do not always perform effectively. There is evidence that professional stereotypes inhibit effective interprofessional teamwork, but they haven’t been explored as a phenomenon that impacts team’s performance and quality of care.ObjectivesTo focus on professional stereotypes emerging in interprofessional teams and examine the contingency effects of interprofessional team’s faultlines, professional stereotypes, and leader’s championship behaviors on team’s quality of care.MethodsA cross-sectional nested sample of 59 interprofessional teams and 284 professionals, working in geriatric long-term-care facilities in Israel. Additionally, five to seven of the residents of each facility were randomly sampled to obtain the outcome variable. Data collection employed a multisource (interprofessional team members), multimethod (validated questionnaires and data from residents’ health records) strategy.ResultsThe results indicated that faultlines are not directly harmful to team’s quality of care; instead, they are likely to impact quality of care only when team stereotypes emerge. Furthermore, whereas teams typified by high professional stereotypes require person-oriented championship leadership, for teams typified by low team stereotypes, championship leadership harms the quality of care they provide.ConclusionThese findings have implications for handling interprofessional teams. Practically, leaders must be well-educated to better analyze team members’ needs and maintain the appropriate leadership style.
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Affiliation(s)
- Galia Sheffer Hilel
- Nutrition Sciences Department, Faculty of Sciences at Tel-Hai College, Kiryat Shmona, Israel
- *Correspondence: Galia Sheffer Hilel,
| | - Anat Drach-Zahavy
- Nursing Department, Faculty of Social Welfare and Health Sciences at Haifa University, Haifa, Israel
| | - Ronit Endevelt
- School of Public Health, Faculty of Social Welfare and Health Sciences at Haifa University, Haifa, Israel
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Middeke J, Palmer K, Lövestam E, Vivanti A, Orrevall Y, Steiber A, Lyons-Wall P, Lo J, Devine A, Lieffers J, Papoutsakis C, Lang NR, Thoresen L, Lloyd L, O'Sullivan TA. Predictors of nutrition care process knowledge and use among dietitians internationally. J Hum Nutr Diet 2021; 35:466-478. [PMID: 34812563 DOI: 10.1111/jhn.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened. METHODS The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression. RESULTS Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002). CONCLUSIONS Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records.
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Affiliation(s)
- Julia Middeke
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Kayla Palmer
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Angela Vivanti
- Research & Development Dietitian, Princess Alexandra Hospital, Brisbane, QLD, Australia.,School of Human Movement and Nutrition Studies, University of Queensland, St Lucia, Queensland, Australia
| | - Ylva Orrevall
- Department of Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden.,Department of Bioscience and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Alison Steiber
- Division of Nutrition and Dietetics, Collage of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SA, Canada
| | - Philippa Lyons-Wall
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA, Australia
| | - Amanda Devine
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Jessica Lieffers
- Division of Nutrition and Dietetics, Collage of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SA, Canada
| | | | - Nanna R Lang
- Department of Nutrition and Health, VIA University College, Horsens, Denmark
| | | | - Lyn Lloyd
- Auckland City Hospital, Auckland, New Zealand
| | - Therese A O'Sullivan
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
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Martino J, Eisenbraun C, Hotson B, Hanning RM, Lövestam E, Lieffers JRL, On Behalf Of The International Ncp/Ncpt Implementation Study Inis Consortium. Use of the Nutrition Care Process and Terminology in Canada: A National and Regional Update. CAN J DIET PRACT RES 2021; 83:2-9. [PMID: 34286625 DOI: 10.3148/cjdpr-2021-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: The purpose of this paper is to understand Canadian dietitians' use of the Nutrition Care Process (NCP) and terminology (NCPT) nationally and by province/territory as well as facilitators, barriers, and attitudes regarding the NCP/NCPT.Methods: Canadian dietitians were invited to complete an online survey (SurveyMonkey) on the NCP/NCPT from February to April 2017 through multiple channels. Data were analyzed using descriptive statistics and nonparametric tests.Results: Overall, there were 500 eligible respondents; the analysis focused on dietitians working in clinical care who were familiar with the NCP (n = 420). In total, 87.9% and 77.5% of respondents reported always/frequently using aspects of the NCP and NCPT in their practice, respectively. There were variations in use by province/territory (P < 0.001); use was more frequent in Alberta and Manitoba versus other provinces/territories. A main barrier to implementation was lack of time; main facilitators to implementation were peer support, management support, and required use of the NCP. The prevalence of many facilitators and barriers varied by province (P < 0.05). Attitudes regarding the NCP/NCPT were variable.Conclusions: Overall, most clinical care dietitians reported some type of use of the NCP/NCPT. There were provincial/territorial variations in use, barriers, and facilitators. These findings provide information to develop strategies to enhance use of the NCP/NCPT in Canada.
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Affiliation(s)
- Jessica Martino
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | | | - Brenda Hotson
- Nutrition & Food Services, Winnipeg Regional Health Authority, Winnipeg, MB
| | - Rhona M Hanning
- School of Public Health Sciences University of Waterloo, Waterloo, ON
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Alkhaldy AA, Allahyani MN, Alghamdi NA, Jeddawi AK, Malibary RM, Al-Othman AM. Status of nutrition care process implementation in hospitals in Jeddah, Saudi Arabia. Clin Nutr ESPEN 2020; 36:53-59. [PMID: 32220369 DOI: 10.1016/j.clnesp.2020.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/19/2020] [Accepted: 02/15/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) are currently implemented by dietetics practitioners worldwide, with various advantages, including ensuring consistency and clarity of dietetics-related healthcare records and the possibility to collect and analyse patient outcomes; however, how Saudi dietitians experience the implementation process is poorly understood. The aim of this study was to explore the experiences of Saudi dietitians of NCP implementation in hospitals in Jeddah. METHODS In this quantitative, cross-sectional study, 56 dietitians were recruited from six principal hospitals in Jeddah. A questionnaire was used to collect data on the characteristics of the dietitians and hospital-related clinical nutrition care performance, the perception and opinions of dietitians towards the NCP, and the status of NCP implementation. RESULTS Almost all dietitians (98%) were aware of the NCP; however, only 27% had received NCP training. Most dietitians (73%) reported that their department currently follows the NCP, while only 26% reported using the standardized NCP, including International Classification of Functioning, Disability & Health - Dietetics (ICF-D)-WHO and International Dietetic & Nutrition Terminology (IDNT) - USA, with 63% following the hospital's own NCP. Reported reasons for hospitals not following the NCP included insufficient dietitians, lack of experience, or conflict with the hospital's nutrition care system. A majority of dietitians reported no perceived barriers to applying the NCP; however, 23% reported NCP documentation as a challenge. CONCLUSIONS The majority of dietitians are aware of the NCP and feel confident to practice; however, the NCP model is not currently implemented in Jeddah hospitals as standard. On-going education, a training program, and an implementation plan should be prioritised.
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Affiliation(s)
- Areej A Alkhaldy
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Manal N Allahyani
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noura A Alghamdi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahad K Jeddawi
- Clinical Nutrition Department at Nutrition Administration, Health Affairs in Jeddah, Ministry of Health, Saudi Arabia
| | - Razan M Malibary
- Department of Surgery, Al Thagher Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Abdulaziz M Al-Othman
- Saudi Society for Clinical Nutrition, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
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6
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Lövestam E, Vivanti A, Steiber A, Boström AM, Devine A, Haughey O, Kiss CM, Lang NR, Lieffers J, Lloyd L, O'Sullivan TA, Papoutsakis C, Peersen C, Thoresen L, Orrevall Y. Barriers and enablers in the implementation of a standardised process for nutrition care: findings from a multinational survey of dietetic professionals in 10 countries. J Hum Nutr Diet 2020; 33:252-262. [PMID: 31912581 DOI: 10.1111/jhn.12700] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND To explore the barriers and enablers experienced by nutrition and dietetic professionals in the implementation of the standardised Nutrition Care Process (NCP) across 10 different countries. NCP related beliefs, motivations and values were investigated and compared. METHODS A validated online survey was disseminated to nutrition and dietetics professionals in 10 countries in the local language during 2017. Cross-sectional associations and differences between countries were explored for level of implementation, barriers/enablers and attitudes/motivation among the respondents. RESULTS Higher NCP implementation was associated with greater occurrence of enabling aspects, as well as fewer occurrences of barriers. The most common enabler was 'recommendation by the national dietetic association' (69%) and the most common barrier was 'lack of time' (39%). A longer experience of NCP use was associated with a more positive attitude towards all NCP aspects. Differences between countries were identified, regarding both the occurrence of barriers/enablers and attitudes/motivations. CONCLUSIONS Implementation efforts need to be tailored to country-specific contexts when implementing a new standard of care framework among nutrition and dietetic professionals. Additional research is needed to further assess the management and workplace strategies to support the development of nutrition and dietetics professionals in multidisciplinary healthcare organisations.
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Affiliation(s)
- E Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - A Vivanti
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- School of Human Movement and Nutrition Studies, University of Queensland, QLD, Australia
| | - A Steiber
- Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - A-M Boström
- Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institute, Huddinge, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- Research& Development unit, Stockholms Sjukhem, Stockholm, Sweden
- Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway
| | - A Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - O Haughey
- Irish Nutrition and Dietetic Institute, Dun Laoghaire, Co., Dublin, Ireland
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - C M Kiss
- Clinical Nutrition, Research and Development, University Department of Geriatric Medicine FELIX PLATTER, Basel, Swiftzerland
| | - N R Lang
- Department of Nutrition and Health, VIA University College, Aarhus N, Denmark
| | - J Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - L Lloyd
- Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand
| | - T A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - C Papoutsakis
- Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - C Peersen
- The municipality of Trondheim, Trondheim, Norway
| | - L Thoresen
- Cancer Clinic, Trondheim University Hospital, Trondheim, Norway
- National Advisory Unit on Disease-Related Malnutrition, Oslo University Hospital, Oslo, Norway
| | - Y Orrevall
- Function Area Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Gäbler G, Coenen M, Fohringer K, Trauner M, Stamm TA. Towards a nationwide implementation of a standardized nutrition and dietetics terminology in clinical practice: a pre-implementation focus group study including a pretest and using the consolidated framework for implementation research. BMC Health Serv Res 2019; 19:920. [PMID: 31783855 PMCID: PMC6884883 DOI: 10.1186/s12913-019-4600-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/03/2019] [Indexed: 02/08/2023] Open
Abstract
Background & Aims In order to assure high quality of nutrition and dietetic care as well as research, the implementation of a standardized terminology, such as the World Health Organization (WHO) International Classification of Functioning, Disability and Health for Dietetics (ICF-Dietetics) is indispensable. The aim of this study was to explore the clinical practicability and applicability of the ICF-Dietetics in the field of nutrition and dietetic practice prior to the implementation in order to develop criteria (points to consider) for a targeted implementation strategy. Methods A focus group study including a pretest of the ICF-Dietetics was conducted. Subsequently, facilitators and barriers for a nationwide implementation of the ICF-Dietetics in clinical nutrition and dietetic practice were identified and linked to interventions (combining theory-based and group-based approach) using the Consolidated Framework of Implementation Research (CFIR) to organize and represent data and summarized in a logic model. Results In the pretest 55 clinical documentations which consisted of 248 different ICF-Dietetics categories were received. In four focus groups with 22 health professionals, 66 relevant higher-level themes and implementation strategy criteria (points to consider) were identified. These themes referred to all five domains of the CFIR, namely intervention characteristics, inner setting, outer setting, characteristics of individuals and implementation process and contained important barriers and facilitators that were linked to six implementation objectives as well as six context requirements and five main actors. Conclusions This study provides facilitators and barriers to be addressed when implementing the ICF-Dietetics in clinical practice and shows potential interventions based on this analysis. A nationwide implementation was mainly seen as a great advantage for enhancing quality and continuity of care and for providing comparable data. However, it requires further refinements and a multifaceted implementation strategy where the engagement of leadership of institutions plays a crucial role. These results have provided a foundation for a targeted implementation strategy to increase the success, reproducibility and comparability.
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Affiliation(s)
- Gabriele Gäbler
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Michaela Coenen
- LMU Munich, Department of Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health und Health Services Research, Marchioninistr. 17, 81377, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - Katrin Fohringer
- Department of Medicine III, Division of Gastroenterology and Hepatology, Medical Nutrition Therapy and Dietetics, Vienna General Hospital, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Michael Trauner
- Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Tanja A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Carpenter A, Mann J, Yanchis D, Campbell A, Bannister L, Vresk L. Implementing a Clinical Practice Change: Adopting the Nutrition Care Process. CAN J DIET PRACT RES 2019; 80:127-130. [PMID: 30907123 DOI: 10.3148/cjdpr-2019-003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Nutrition Care Process (NCP), created by the Academy of Nutrition and Dietetics, provides a framework that encourages critical thinking and promotes uniform documentation by Registered Dietitians (RD). Additionally, it creates a link between the nutrition assessment, nutrition intervention, and the predicted or actual nutrition outcome. NCP has been integrated into a number of institutions in Canada and internationally. A committee of nonmanagement RDs at the Hospital for Sick Children led the Department of Clinical Dietetics in adopting the NCP. The committee developed and consecutively delivered a tailored education plan to 5 groups of RDs within the department. Additional resources were developed to complement the learning plan. The committee administered informal pre- and post-education surveys to measure outcomes. RDs reported receiving adequate training and felt confident implementing NCP into their practice. Adopting the NCP was well-received and RDs within the department continue to integrate it into their current practice.
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Affiliation(s)
- Andrea Carpenter
- Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON.,Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
| | - Jordan Mann
- Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON.,Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
| | - Dianna Yanchis
- Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON.,Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
| | - Alison Campbell
- Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON.,Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
| | - Louise Bannister
- Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON.,Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
| | - Laura Vresk
- Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON.,Department of Clinical Dietetics, Hospital for Sick Children, Toronto, ON
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Lövestam E, Vivanti A, Steiber A, Boström AM, Devine A, Haughey O, Kiss CM, Lang NR, Lieffers J, Lloyd L, O'Sullivan TA, Papoutsakis C, Thoresen L, Orrevall Y. The International Nutrition Care Process and Terminology Implementation Survey: Towards a Global Evaluation Tool to Assess Individual Practitioner Implementation in Multiple Countries and Languages. J Acad Nutr Diet 2018; 119:242-260. [PMID: 30552017 DOI: 10.1016/j.jand.2018.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 09/04/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The Nutrition Care Process (NCP) and NCP Terminology (NCPT) is a systematic framework for critical thinking, decision making, and communication for dietetics practitioners worldwide, aiming to improve quality and patient safety in nutrition care. Although dietetics practitioners in several countries have implemented the NCP/NCPT during recent years, to date there is no globally validated instrument for the evaluation of NCP/NCPT implementation that is available in different languages and applicable across cultures and countries. OBJECTIVE The aim of this study was to develop and test a survey instrument in several languages to capture information at different stages of NCP/NCPT implementation across countries and cultures. SETTING In this collaboration between dietetics practitioners and researchers from 10 countries, an International NCP/NCPT Implementation Survey tool was developed and tested in a multistep process, building on the experiences from previous surveys. The tool was translated from English into six other languages. It includes four modules and describes demographic information, NCP/NCPT implementation, and related attitudes and knowledge. METHODS The survey was reviewed by 42 experts across 10 countries to assess content validity and clarity. After this, 30 dietetics practitioners participated in cognitive interviews while completing the survey. A pilot study was performed with 210 participants, of whom 40 completed the survey twice within a 2- to 3-week interval. RESULTS Scale content validity index average was 0.98 and question clarity index was 0.8 to 1.0. Cognitive interviews and comments from experts led to further clarifications of the survey. The repeated pilot test resulted in Krippendorff's α=.75. Subsequently, refinements of the survey were made based on comments submitted by the pilot survey participants. CONCLUSIONS The International NCP/NCPT Implementation Survey tool demonstrated excellent content validity and high test-retest reliability in seven different languages and across an international context. This tool will be valuable in future research and evaluation of implementation strategies.
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O'Sullivan TA, Lo J, Vivanti A. Predictors of nutrition care process and terminology use, applicability and importance within Asia-Pacific dietitians. Nutr Diet 2018; 76:455-461. [PMID: 30182523 DOI: 10.1111/1747-0080.12467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/13/2018] [Accepted: 07/25/2018] [Indexed: 11/27/2022]
Abstract
AIM Many dietitians are yet to incorporate the Nutrition Care Process and Terminology (NCPT) into practice. The present study investigated factors predicting (i) NCPT use, (ii) perceived importance of NCPT implementation and (iii) perceived NCPT applicability to personal dietetic practice among dietitians in the Asia-Pacific region. METHODS Dietetic association members from Australia, New Zealand and Singapore were invited to participate in an online survey assessing NCPT implementation, knowledge, and self-rated familiarity, attitudes, benefits, concerns, barriers, and enablers. Forward stepwise logistic regression used all factors to identify predictive dietetic characteristics for current NCPT use, importance or applicability to practice. RESULTS A total of 377 dietitians (5%-55% of national dietetic memberships surveyed) completed at least one survey question. In logistic regression models, independent positive predictors of current NCPT users were knowledge (P = 0.003), confidence to implement (P = 0.036), confidence to write nutrition diagnoses (P = 0.002) and experiencing managerial support (P = 0.004). Not seeing a reason to change was a significant negative predictor of NCPT use (P = 0.003). An independent positive predictor of dietitians viewing NCPT implementation as important was feeling that it will improve patient care (P < 0.001), while negative predictors were seeing minimal benefit in changing (P < 0.001) and a preference to continue with current routine (P = 0.015). Independent positive predictors of dietitians viewing NCPT as applicable to their practice were NCPT knowledge (P = 0.009), seeing the value of NCPT (P < 0.001) and attendance at workshops or conferences (P = 0.014). CONCLUSIONS NCPT implementation may be enhanced thorough activities building confidence, gaining managerial corroboration and demonstration of NCPT benefits, including improved patient care.
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Affiliation(s)
- Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Angela Vivanti
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Human Movement and Nutrition Studies, University of Queensland, Brisbane, Queensland, Australia
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11
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Matthews KL, Palmer MA, Capra SM. The accuracy and consistency of nutrition care process terminology use in cases of refeeding syndrome. Nutr Diet 2017; 75:331-336. [PMID: 29114984 DOI: 10.1111/1747-0080.12389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 07/31/2017] [Accepted: 08/29/2017] [Indexed: 01/04/2023]
Abstract
AIM Using standardised terminology in acute care has encouraged consistency in patient care and the evaluation of outcomes. As such, the Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) may assist dietitian nutritionists in the delivery of high quality nutrition care worldwide; however, limited research has been conducted examining the consistency and accuracy of its use. We aimed to examine the NCPT that dietitian nutritionists would use to formulate a diagnostic statement relating to refeeding syndrome (RFS). METHODS A multimethod action research approach was used, incorporating two projects. The first was a survey examining Australian dietitian nutritionists' (n = 195) opinions regarding NCPT use in cases of RFS. To establish if results were similar internationally, an interview was then conducted with 22 dietitian nutritionists working within 10 different countries. RESULTS 'Imbalance of nutrients' was only identified as a correct code by 17% of respondents in project 1. No mention of this term was made in project 2. Also 86% of respondents incorrectly selected more than one diagnostic code. The majority of respondents (80%, n = 52/65) who incorrectly selected 'Malnutrition', without also selecting 'Imbalance of nutrients', selected 'reduce intake' as an intervention, suggesting some misunderstanding in the requirement for interrelated diagnoses, interventions and goals. CONCLUSIONS Our findings demonstrate that there is limited accuracy and consistency in selecting nutritional diagnostic codes in relation to RFS. Respondents also demonstrated limited knowledge regarding appropriate application of the NCP and NCPT. Implementation practices may require further refinement, as accurate and consistent use is required to procure the benefits of standardised terminology.
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Affiliation(s)
- Kylie L Matthews
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Michelle A Palmer
- Nutrition and Dietetics, Logan hospital, Meadowbrook, Queensland, Australia
| | - Sandra M Capra
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Queensland, Australia
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12
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Lövestam E, Boström AM, Orrevall Y. Nutrition Care Process Implementation: Experiences in Various Dietetics Environments in Sweden. J Acad Nutr Diet 2017; 117:1738-1748. [DOI: 10.1016/j.jand.2017.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/31/2017] [Indexed: 11/30/2022]
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13
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Swan WI, Vivanti A, Hakel-Smith NA, Hotson B, Orrevall Y, Trostler N, Beck Howarter K, Papoutsakis C. Nutrition Care Process and Model Update: Toward Realizing People-Centered Care and Outcomes Management. J Acad Nutr Diet 2017; 117:2003-2014. [PMID: 28988837 DOI: 10.1016/j.jand.2017.07.015] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Indexed: 11/25/2022]
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Vivanti A, O'Sullivan TA, Porter J, Hogg M. Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system. Nutr Diet 2017; 74:372-380. [DOI: 10.1111/1747-0080.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 11/18/2016] [Accepted: 01/15/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Angela Vivanti
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Brisbane Queensland Australia
- School of Human Movement and Nutrition Studies; University of Queensland; Brisbane Queensland Australia
| | - Therese A. O'Sullivan
- School of Medical and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Jane Porter
- School of Medical and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Marion Hogg
- Department of Nutrition and Dietetics; Ipswich Hospital; Brisbane Queensland Australia
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Vivanti A, Lewis J, O'Sullivan TA. The Nutrition Care Process Terminology: Changes in perceptions, attitudes, knowledge and implementation amongst Australian dietitians after three years. Nutr Diet 2017; 75:87-97. [DOI: 10.1111/1747-0080.12347] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/22/2016] [Accepted: 01/22/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Angela Vivanti
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Woolloongabba Queensland Australia
- School of Human Movement and Nutrition Studies; University of Queensland; St. Lucia Queensland Australia
| | - Jessica Lewis
- School of Human Movement and Nutrition Studies; University of Queensland; St. Lucia Queensland Australia
| | - Therese A. O'Sullivan
- School of Medical and Health Sciences; Edith Cowan University; Joondalup Queensland Australia
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Baek YJ, Oh NG, Sohn CM, Woo MH, Lee SM, Ju DL, Seo JS. Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian. Clin Nutr Res 2017; 6:99-111. [PMID: 28503506 PMCID: PMC5426211 DOI: 10.7762/cnr.2017.6.2.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 11/19/2022] Open
Abstract
This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. ‘Nutrition intervention’ was 4.5 ± 0.5 for task importance, ‘nutrition assessment’ was 4.0 ± 0.7 for performance, and ‘nutrition diagnosis’ was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were ‘checking basic information,’ ‘checking medical history and therapy plan,’ ‘decision of nutritional needs,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ The tasks with high importance but low performance were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘monitoring of nutrition intervention process.’ The tasks of both high importance and high difficulty were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘supply of foods and nutrients,’ ‘education of nutrition and self-management,’ and ‘monitoring of nutrition intervention process.’ The tasks of both high performance and high difficulty were ‘documentation of nutrition assessment,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’
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Affiliation(s)
- Young Jin Baek
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Korea
| | - Na Gyeong Oh
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Korea
| | - Cheong-Min Sohn
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
| | - Mi-Hye Woo
- Department of Nutrition Team, Kyung Hee University Medical Center, Seoul 02447, Korea
| | - Seung Min Lee
- Department of Food and Nutrition, Sungshin Women's University, Seoul 01133, Korea
| | - Dal Lae Ju
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul 03080, Korea
| | - Jung-Sook Seo
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Korea
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