More-2-Eat Phase 2: Scaling and Spread of the Integrated Nutrition Pathway for Acute Care
More-2-Eat Phase 2: Spread/Scaling up Improved Nutrition Care to Detect and Treat Hospital Malnutrition.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Malnutrition in hospital patients is a growing problem, with 20-45% of patients already malnourished at admission. As 70% of malnourished patients are also frail, early detection and treatment of malnutrition is one way to improve the outcomes of frail older adults. To improve the detection and treatment of these conditions, the PI developed the Integrated Nutrition Pathway for Acute Care (INPAC) that guides hospital staff on when to conduct key nutrition care activities to improve outcomes (e.g. screening at admission).
In More-2-Eat (April 2015-March 2017), 5 Canadian hospital units in 4 provinces received funding to implement INPAC. Each hospital, with support from a research team had 1 year to implement INPAC. All 5 hospitals were successful in improving detection and treatment of malnutrition, and started to screen for frailty. Clinical care was transformed in the study units; for example all sites progressed from low baseline or no screening at admission to a rate of 75%. Findings also demonstrate improvement in clinical outcomes such as a shorter length of stay. An online INPAC Implementation Toolkit was developed to promote mobilization of this knowledge. What is not known is whether or not the results can be replicated under normal circumstances (i.e., no external funding for implementation at a hospital site).
To sustain and expand on this success, a Phase 2 knowledge translation project is proposed that will involve the five original Phase 1 sites and five further hospitals as Phase 2 sites. The goal of the second phase is to see if Phase 1 sites can spread success to other units within their hospitals and if Phase 2 sites can achieve similar results across a broader group of patients.
The end product will be a sustainable model including a community of practice supported by our partner the Canadian Malnutrition Task Force, and a self-serve registry that allows sites to collect and report data to change their practice. Investigators will also confirm capacity of INPAC activities to improve clinical outcomes across diverse settings. This knowledge translation and implementation study will demonstrate the potential to transform clinical nutrition care, benefiting all pre-frail and frail older adults.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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Alberta
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Edmonton, Alberta, Canada
- Royal Alexander Hospital
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Manitoba
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Brandon, Manitoba, Canada
- Brandon Regional Health Centre
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Winnipeg, Manitoba, Canada
- Concordia Hospital
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Nova Scotia
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Halifax, Nova Scotia, Canada
- Victoria General Hospital
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Ontario
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London, Ontario, Canada
- London Health Sciences Centre
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Napanee, Ontario, Canada
- Lennox Addington County General Hospital
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Niagara Falls, Ontario, Canada
- Niagara Health Systems
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Thunder Bay, Ontario, Canada
- Thunder Bay Regional Health Sciences Centre
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Saskatchewan
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Regina, Saskatchewan, Canada
- Pasqua Hospital
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- Patient on the study unit
Exclusion Criteria:
- patients not on the study unit
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: Autre
- Perspectives temporelles: Éventuel
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
|
Royal Alexandria
Administrative records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
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|
Pasqua Regional hospital
Administrative records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
|
|
Concordia Hospital
Administrative records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
|
|
Niagara General Hospital
Administrative records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
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|
Hospital 6
Administrative Records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
|
|
Hospital 7
Administrative Records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
|
|
Hospital 8
Administrative Records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
|
|
Hospital 9
Administrative Records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
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|
Hospital 10
Administrative records
|
algorithm to guide care processes with respect to nutrition e.g.
screening on admission, diagnosis with subjective global assessment, early treatment with medication pass of oral nutritional supplement
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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success with implementation
Délai: 19 months
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rates of screening, diagnosis and treatment with medication pass per month of the study
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19 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Adverse events while in hospital (fall, new infection etc.)
Délai: 19 months
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19 months
|
|
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Length of stay
Délai: 19 months
|
Average length of stay for patients admitted to the study unit; monthly average
|
19 months
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Readmission rate
Délai: 19 months
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number of patients per month discharged and readmitted to the hospital within 30 days
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19 months
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Heather Keller, PhD, University of Waterloo
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- KT2017-01
Plan pour les données individuelles des participants (IPD)
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Description du régime IPD
Délai de partage IPD
Type d'informations de prise en charge du partage d'IPD
- Code analytique
Informations sur les médicaments et les dispositifs, documents d'étude
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