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Iorio-Aranha F, de Freitas C, Rocha-Sousa A, Azevedo A, Barbosa-Breda J. Nationwide consensus on quality indicators to assess glaucoma care: A modified Delphi approach. Eur J Ophthalmol 2024; 34:217-225. [PMID: 37069806 PMCID: PMC10757386 DOI: 10.1177/11206721231170033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 03/28/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Performance assessments are essential to tracking and improving quality in health care systems. Key aspects of the care process that act as indicators must be measured in order to gain an in-depth understanding of a care unit's operation. Without standardized quality indicators (QIs), it is difficult to characterize and compare the abilities of institutions to achieve excellence. The aim of this study is to reach a consensus among glaucoma specialists concerning the development of a set of QIs to assess the performance of glaucoma care units. METHODS A two-round Delphi technique was performed among glaucoma specialists in Portugal, using a 7-point Likert scale. Fifty-three initial statements (comprising process, structure, and outcome indicators) were evaluated and participants had to agree on which ones would be part of the final set of QIs. RESULTS By the end of both rounds, 28 glaucoma specialists reached consensus on 30/53 (57%) statements, including 19 (63%) process indicators (mainly relating to the proper implementation of complementary exams and the setting of follow-up intervals), 6 (20%) structure indicators, and 5 (17%) outcome indicators. Of the indicators that were part of the final list, functional and structural aspects of glaucoma progression and the availability of surgical/laser procedures were the most prevalent. CONCLUSIONS A set of 30 QIs for measuring the performance of glaucoma units was developed using a consensus methodology involving experts in the field. Their use as measurement standards would provide important information about unit operations and allow further implementation of quality improvements.
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Affiliation(s)
- Flavio Iorio-Aranha
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Ophthalmology, Faculty of Medicine, Universidade de Brasilia, Brasilia, Brasil
| | - Cláudia de Freitas
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Amândio Rocha-Sousa
- UnIC@RISE, Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Ana Azevedo
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Hospital Epidemiology Center, Centro Hospitalar Universitário São João, Porto, Portugal
| | - João Barbosa-Breda
- UnIC@RISE, Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Neurosciences, KULeuven, Research Group Ophthalmology, Leuven, Belgium
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2
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Cook N, Porter J, Goodwin D, Collins J. Diverting Food Waste From Landfill in Exemplar Hospital Foodservices: A Qualitative Study. J Acad Nutr Diet 2023:S2212-2672(23)01763-X. [PMID: 38142741 DOI: 10.1016/j.jand.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The US Environmental Protection Agency Food Recovery Hierarchy suggests methods for diverting food waste from landfill. Knowledge of how hospital foodservices implement food waste management strategies could help modernize food waste practices. OBJECTIVE The aim of this study was to explore hospital staff members' experiences of implementing a food waste management strategy to divert food waste from landfill in their hospital foodservice, including the journey, challenges, and facilitators of this practice change. DESIGN A qualitative study was conducted in 2022-2023 using semi-structured interviews. PARTICIPANTS/SETTING Eighteen participants were staff members with knowledge of the food waste management strategy from 14 exemplar hospitals in United States, Spain, Scotland, and Australia using strategies to divert food waste from landfill within the last 10 years. ANALYSES PERFORMED Mapping and thematic analysis were undertaken to code and identify themes from the interviews that described staff members' experiences of the journey to implement the strategy. RESULTS Six hospitals donated food, 1 transferred food waste for animal feed, 4 used an industrial solution, and 3 sent food waste for composting. A common journey pathway for successful implementation was identified from participants' experiences. It features the following 6 phases: idea, preparation, roll out, maintenance, established practice, and evolution. Facilitators included legislation, enthusiastic staff members, executive support, and "luck." Challenges were smells, occasions when food waste was not collected, equipment breakage, and funding depletion. CONCLUSIONS This study identified a common journey pathway for implementing a food waste management strategy in hospital foodservices that can be used to anticipate and prepare for the steps in the implementation process.
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Affiliation(s)
- Nathan Cook
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.
| | - Judi Porter
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia; Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Denise Goodwin
- BehaviourWorks Australia Health & Social Programs, Monash University, Clayton, VIC, Australia; Monash Sustainable Development Institute, Monash University, Clayton, VIC, Australia
| | - Jorja Collins
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia; Eastern Health, Box Hill, VIC, Australia
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3
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Alston L, Heaney S, Kent K, Godrich S, Kocanda L, Herbert J, Schumacher T, Brown LJ. Rural nutrition and dietetics research-Future directions. Aust J Rural Health 2023; 31:1027-1031. [PMID: 37723938 DOI: 10.1111/ajr.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023] Open
Abstract
AIM The aim of this study was to summarise key evidence from recent Australian rural nutrition research and provide recommendations for future nutrition and dietetics research with rural communities. CONTEXT Clear evidence demonstrates that diet plays a role in the health gap between rural and metropolitan Australia. Despite the opportunity to address the health of rural Australians through better nutrition, alarmingly low investment in nutrition and dietetics research has occurred historically, and over the past decade. APPROACH A review of the evidence was undertaken by rural nutrition and dietetics leaders to provide a commentary piece to inform future rural nutrition research efforts. CONCLUSION Establishing strong, collaborative place-based nutrition and dietetics research teams are necessary to combat the significant gaps in the scientific knowledge of solutions to improve nutrition in rural Australia. Further, dieticians and nutritionists who live in and understand the rural contexts are yet to be fully harnessed in research, and better engaging with these professionals will have the best chance of successfully addressing the nutrition-related disease disparity between rural and metropolitan Australia.
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Affiliation(s)
- Laura Alston
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Victoria, Warrnambool, Australia
- Research Unit, Colac Area Health, Victoria, Colac, Australia
| | - Susan Heaney
- Department of Rural Health, University of Newcastle, New South Wales, Port Macquarie, Australia
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
| | - Katherine Kent
- School of Health Science, Western Sydney University, New South Wales, Campbelltown, Australia
- School of Health Sciences, University of Tasmania, Tasmania, Launceston, Australia
| | - Stephanie Godrich
- Centre for People, Place and Planet, Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Bunbury, Australia
| | - Lucy Kocanda
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
- Dietetics Department, Tamworth Rural Referral Hospital, New South Wales, Tamworth, Australia
| | - Jaimee Herbert
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Victoria, Warrnambool, Australia
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
| | - Tracy Schumacher
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
| | - Leanne J Brown
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
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Rouse D, McDonald D, Tynan A. Using a modified Delphi method to identify research priorities in an Australian regional health service. International Journal of Healthcare Management 2023. [DOI: 10.1080/20479700.2023.2168329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Donna Rouse
- The Research Support Team, Darling Downs Health, Toowoomba, Australia
| | - Daniel McDonald
- The Research Support Team, Darling Downs Health, Toowoomba, Australia
| | - Anna Tynan
- The Research Support Team, Darling Downs Health, Toowoomba, Australia
- Southern Queensland Rural Health, The University of Queensland, Toowoomba, Australia
- The Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
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5
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Truby H. The United Nations Sustainable Development Goals: Aspirational or obtainable? Nutr Diet 2023; 80:4-7. [PMID: 36755408 DOI: 10.1111/1747-0080.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Helen Truby
- University of Queensland, Brisbane, Australia.,Australian Academy of Science Committee for Nutrition, Australia
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Asher RC, Jakstas T, Lavelle F, Wolfson JA, Rose A, Bucher T, Dean M, Duncanson K, van der Horst K, Schonberg S, Slater J, Compton L, Giglia R, Fordyce-Voorham S, Collins CE, Shrewsbury VA. Development of the Cook-EdTM Matrix to Guide Food and Cooking Skill Selection in Culinary Education Programs That Target Diet Quality and Health. Nutrients 2022; 14:nu14091778. [PMID: 35565746 PMCID: PMC9103694 DOI: 10.3390/nu14091778] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 12/04/2022] Open
Abstract
Culinary education programs are generally designed to improve participants’ food and cooking skills, with or without consideration to influencing diet quality or health. No published methods exist to guide food and cooking skills’ content priorities within culinary education programs that target improved diet quality and health. To address this gap, an international team of cooking and nutrition education experts developed the Cooking Education (Cook-EdTM) matrix. International food-based dietary guidelines were reviewed to determine common food groups. A six-section matrix was drafted including skill focus points for: (1) Kitchen safety, (2) Food safety, (3) General food skills, (4) Food group specific food skills, (5) General cooking skills, (6) Food group specific cooking skills. A modified e-Delphi method with three consultation rounds was used to reach consensus on the Cook-EdTM matrix structure, skill focus points included, and their order. The final Cook-EdTM matrix includes 117 skill focus points. The matrix guides program providers in selecting the most suitable skills to consider for their programs to improve dietary and health outcomes, while considering available resources, participant needs, and sustainable nutrition principles. Users can adapt the Cook-EdTM matrix to regional food-based dietary guidelines and food cultures.
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Affiliation(s)
- Roberta C. Asher
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.C.A.); (T.J.); (A.R.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
| | - Tammie Jakstas
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.C.A.); (T.J.); (A.R.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
| | - Fiona Lavelle
- School of Biological Sciences, Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK; (F.L.); (M.D.)
| | - Julia A. Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Anna Rose
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.C.A.); (T.J.); (A.R.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
| | - Tamara Bucher
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Moira Dean
- School of Biological Sciences, Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK; (F.L.); (M.D.)
| | - Kerith Duncanson
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
- School of Medicine and Public Health, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Klazine van der Horst
- School of Health Professions, Bern University of Applied Sciences, 3012 Bern, Switzerland; (K.v.d.H.); (S.S.)
| | - Sonja Schonberg
- School of Health Professions, Bern University of Applied Sciences, 3012 Bern, Switzerland; (K.v.d.H.); (S.S.)
| | - Joyce Slater
- Department of Food and Human Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | - Leanne Compton
- Victorian Curriculum and Assessment Authority, Melbourne, VIC 3000, Australia;
| | - Roslyn Giglia
- Foodbank Western Australia, Perth, WA 6105, Australia;
| | | | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.C.A.); (T.J.); (A.R.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
| | - Vanessa A. Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.C.A.); (T.J.); (A.R.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (T.B.); (K.D.)
- Correspondence: ; Tel.: +61-4921-7860
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7
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Barbour L, Bicknell E, Brimblecombe J, Carino S, Fairweather M, Lawrence M, Slattery J, Woods J, World E. Dietitians Australia position statement on healthy and sustainable diets. Nutr Diet 2022; 79:6-27. [PMID: 35233909 PMCID: PMC9311218 DOI: 10.1111/1747-0080.12726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 12/12/2022]
Abstract
It is the position of Dietitians Australia that to promote human and planetary health, a food system transformation is needed that enables the population to adopt healthy and sustainable diet-related practices. A healthy and sustainable diet must (i) be nutritionally adequate, healthy and safe, (ii) have low environmental impact and be protective of natural resources and biodiversity, (iii) be culturally acceptable and (iv) be accessible, economically fair and affordable. Dietitians Australia acknowledges that it is critical to prioritise Indigenous knowledges in consultation, policy-making and implementation processes to achieve these recommendations. In facilitating the uptake of healthy and sustainable diets, dietitians are contributing to the transformation of our current food system that is urgently required to nourish present and future generations within planetary boundaries. In developing this position statement, opportunities for future research have been identified including those to advance the professions' capacity to improve environmental sustainability outcomes across all areas of practice. To achieve a population-level shift towards this diet, Dietitians Australia recommends: (i) the development of a National Food and Nutrition Strategy which honours Indigenous knowledges on food systems, (ii) the integration of sustainability principles in Australia's dietary guidelines, (iii) the reorientation of our food environment to prioritise access to healthy and sustainable foods, and (iv) investment in capacity building activities to equip the current and future nutrition and dietetics workforce.
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Affiliation(s)
- Liza Barbour
- Department of Nutrition, Dietetics & FoodMonash UniversityNotting HillVictoriaAustralia
| | | | - Julie Brimblecombe
- Department of Nutrition, Dietetics & FoodMonash UniversityNotting HillVictoriaAustralia
| | - Stefanie Carino
- Department of Nutrition, Dietetics & FoodMonash UniversityNotting HillVictoriaAustralia
| | | | - Mark Lawrence
- Deakin UniversityInstitute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesGeelongAustralia
| | | | - Julie Woods
- Deakin UniversityInstitute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesGeelongAustralia
| | - Elizabeth World
- Dietitians AustraliaDeakinAustralian Capital TerritoryAustralia
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8
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Porter J. Contemporary syntheses in nutrition and dietetics. Nutr Diet 2022; 79:4-5. [PMID: 35233910 DOI: 10.1111/1747-0080.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Judi Porter
- Deakin University, Geelong, Victoria, Australia.,Editor in Chief, Nutrition & Dietetics
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9
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Affiliation(s)
- Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia.,Monash Centre for Scholarship in Health Education, Monash University, Clayton, Australia
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10
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Affiliation(s)
- Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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11
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Bell JJ, Young AM, Hill JM, Banks MD, Comans TA, Barnes R, Keller HH. Systematised, Interdisciplinary Malnutrition Program for impLementation and Evaluation delivers improved hospital nutrition care processes and patient reported experiences - An implementation study. Nutr Diet 2021; 78:466-475. [PMID: 33817934 DOI: 10.1111/1747-0080.12663] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 01/01/2023]
Abstract
AIM Models of hospital malnutrition care reliant on dietitians can be inefficient and of limited effectiveness. This study evaluated whether implementing the Systematised, Interdisciplinary Malnutrition Program for impLementation and Evaluation (SIMPLE) improved hospital nutrition care processes and patientreported experiences compared with traditional practice. METHODS A multi-site (five hospitals) prospective, pre-post study evaluated the facilitated implementation of SIMPLE, a malnutrition care pathway promoting proactive nutrition support delivered from time of malnutrition screening by the interdisciplinary team, without need for prior dietetic assessment. Implementation was tailored to local site needs and resources. Nutrition care processes delivered to inpatients who were malnourished or at-risk of malnutrition were identified across diagnosis, intervention, and monitoring domains using standardised audits from medical records, foodservice systems and patient-reported nutrition experience measures. RESULTS Pre-implementation (n = 365) and post-implementation (n = 397) cohorts were similar for age (74 vs 73 years), gender (47.1% vs 48.6% female), and nutrition risk status (46.6% vs 45.3% at-risk). Post-implementation, at-risk participants were more likely to receive enhanced food and fluids (68.5% vs 83.9%; P < .01), nutrition information (30.9% vs 47.2%; P < .01), mealtime assistance where required (61.4% vs 77.9% P = .04), nutrition monitoring (25.2% vs 46.3%; P < .01) and care planning (17.8% vs 27.7%; P = .01). Patient-reported nutrition experience measures confirmed improved nutrition care. There was no difference in dietetic occasions of service per patient (1.51 vs 1.25; P = .83). CONCLUSIONS Tailored SIMPLE implementation improves nutrition care processes and patient reported nutrition experience measures for at-risk inpatients within existing dietetic resources.
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Affiliation(s)
- Jack J Bell
- Allied Health, The Prince Charles Hospital, Metro North HHS, Brisbane, Queensland, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Adrienne M Young
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jan M Hill
- Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Merrilyn D Banks
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Tracy A Comans
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Rhiannon Barnes
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada.,Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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12
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Jong J, Porter J, Palermo C, Ottrey E. Meals beyond the bedside: An ethnographic exploration of staffs' perspectives and experiences of communal dining in subacute care. Nurs Health Sci 2021; 23:372-380. [PMID: 33438822 DOI: 10.1111/nhs.12812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 12/25/2022]
Abstract
Communal dining offers multiple benefits for hospital patients, yet dining rooms may be underutilized in practice. This study aimed to understand and explore staffs' perspectives and experiences of communal dining in subacute care, and the impacts on staff mealtime practice. Using qualitative, ethnographic methodology, 94 hours of fieldwork were conducted across two subacute care wards. Participants were staff involved in nutrition care or present on the ward at mealtimes. Ninety-one semistructured and ethnographic interviews were conducted with 59 staff, and 54 episodes of observation captured more than 190 staff. Interviews and field notes were thematically analyzed using an inductive approach. Three themes were identified: (i) benefits to patients; (ii) logistical and practical challenges; and (iii) supportive cultural factors. While staff recognized how communal dining benefited patients, logistical and practical challenges impacted their ability to facilitate it in practice. Healthcare organizations seeking to embed communal dining into the mealtime routine should recognize that clear delineation of staff roles and responsibilities, and cultural change involving normalization, setting expectations, and collective advocacy may be needed to optimize benefits for patients.
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Affiliation(s)
- Jessica Jong
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Judi Porter
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Ella Ottrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia.,Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
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13
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Rushton A, Edwards A, Bauer J, Bell JJ. Dietitian assistant opportunities within the nutrition care process for patients with or at risk of malnutrition: a systematic review. Nutr Diet 2021; 78:69-85. [PMID: 33416208 DOI: 10.1111/1747-0080.12651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
AIM Shifting to models of care that incorporate delegation of nutrition care process actions to dietitian assistants could facilitate effective and efficient nutrition care delivery. This review aimed to determine if delegation of malnutrition care activities to dietitian assistants, when compared with routine nutrition care practices influences patient, healthcare and/or workforce outcomes for adult hospital inpatients with or at risk of malnutrition. METHODS This review was undertaken in accordance with PRISMA guidelines, with five databases (CINAHL, Medline, PsycINFO, Embase and Scopus) searched systematically for studies published up to and including February 2020. Exclusion criteria included review articles and studies conducted in community settings. RESULTS The search yielded 3431 results, with 11 studies eligible for inclusion. Across all domains of the nutrition care process, there is emerging evidence dietitian assistants may improve the delivery of nutrition care practices, patient, healthcare and workforce outcomes. Findings demonstrated various roles and scope of dietitian assistants' practice throughout the studies. Positive patient outcomes were found when dietitian assistants were part of a multi-disciplinary model of care. CONCLUSIONS Implementing delegation of components of the nutrition care process to dietitian assistants is vital in the current health climate and should be considered in a future multidisciplinary model of nutrition care. Exploration of dietitian assistant roles and opportunities are required to expand and strengthen the evidence.
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Affiliation(s)
- Alita Rushton
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Chermside, Queensland, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Anna Edwards
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Jack J Bell
- Department of Nutrition and Dietetics, The Prince Charles Hospital, Chermside, Queensland, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
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14
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McLaren-Hedwards T, D'cunha K, Elder-Robinson E, Smith C, Jennings C, Marsh A, Young A. Effect of communal dining and dining room enhancement interventions on nutritional, clinical and functional outcomes of patients in acute and sub-acute hospital, rehabilitation and aged-care settings: A systematic review. Nutr Diet 2021; 79:140-168. [PMID: 33416215 DOI: 10.1111/1747-0080.12650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/21/2020] [Accepted: 11/04/2020] [Indexed: 11/30/2022]
Abstract
AIMS This review aimed to synthesise evidence on the impact of communal dining and/or dining room enhancement interventions on nutritional, clinical and functional outcomes of patients in hospital (acute or subacute), rehabilitation and residential aged-care facility settings. METHODS Five electronic databases were searched in March 2020. Included studies considered the impact of communal dining and/or dining room enhancements on outcomes related to malnutrition in hospital (acute or subacute), rehabilitation and residential aged care facility settings. Risk of bias was assessed using the Academy of Nutrition and Dietetics quality checklist. Overall quality was assessed using GRADEpro software. Outcome data were combined narratively for communal dining and dining room enhancements respectively. RESULTS Eighteen articles from 17 unique studies were identified. Of these studies, one was a randomised control trial (moderate quality) and 16 were observational studies (all low quality). Communal dining interventions (four studies, n = 490) were associated with greater energy and protein intake and higher measures of quality of life than non-communal mealtime settings. Dining room enhancement interventions (14 studies, n = 912), overall, contributed to increased intake of food, energy, protein and fluid. CONCLUSIONS Results indicate that communal dining and/or dining room enhancement has a positive impact on several outcomes of interest, however, most available evidence is of low quality. Therefore, there is a need for further large-scale, well-designed experimental studies to assess the potential impacts of these interventions.
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Affiliation(s)
- Taya McLaren-Hedwards
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Kelly D'cunha
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Elaina Elder-Robinson
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Claire Smith
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Cindy Jennings
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Abigail Marsh
- Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Adrienne Young
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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15
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Sossen L, Bonham M, Porter J. An investigation of recommended serve food portions and attaining energy and protein requirements in older adults living in residential care. J Hum Nutr Diet 2020; 34:374-383. [PMID: 33068454 DOI: 10.1111/jhn.12824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ageing populations show a propensity for reduced food intake, which impacts nutritional adequacy. Nutrition guidelines for residential care homes (RCHs) are currently based on serve size of core food groups and do not consider nutrient density. The present study aimed to investigate the weight of foods served/consumed compared to recommended serve sizes and to compare energy and protein intake with individual requirements. METHODS This was an observational study of older adults living in four RCHs. Dietary intake was estimated through the difference between weighed reference meals and a single, double-weighed 24-h food plate waste collected from each participant. FoodWorks9® (Xyris® Software, Brisbane, Australia) was used to calculate energy, protein and serves of core food groups from food intake and the menu provided to recommended serve sizes. Individual intake was compared with nutrition guidelines and estimated energy and protein requirements. RESULTS Across 420 participants, 9.8% completed a main meal (lunch or dinner). The servings provided [248 g; interquartile range (IQR) = 206-290 g] were less than the recommended servings for a main meal (306 g = protein/starch/two vegetables), with 157 g (IQR = 109-221 g) consumed. The menu provided for minimum serves of all core food groups except for dairy. Median energy intake (n = 389) (5272 kJ day-1 , IQR = 4229-6720 kJ) and protein intake (47.3 g day-1 , IQR = 35.9-60.8 g) were less than estimated requirements (8181 kJ day-1 , IQR = 7300-9338 kJ day-1 ; 76.7 g day-1 , IQR = 66.7-90.8 g). CONCLUSIONS Nutritional needs were not met in this cohort. The findings of the present study highlight the need for smaller, nutrient-dense meals and revised menu standards to ensure nutritional adequacy in this vulnerable population.
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Affiliation(s)
- L Sossen
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - M Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - J Porter
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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16
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Ash S. Contemporary issues in dietetics. Nutr Diet 2020; 77:403-405. [DOI: 10.1111/1747-0080.12640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Susan Ash
- School of Exercise and Nutrition Sciences Queensland University of Technology Brisbane Queensland Australia
- School of Clinical Sciences, Monash Health Faculty of Medicine, Nursing and Health Sciences, Monash University Melbourne Victoria Australia
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