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.
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
連絡先と場所
研究場所
-
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Alberta
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Edmonton、Alberta、カナダ
- Royal Alexander Hospital
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Manitoba
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Brandon、Manitoba、カナダ
- Brandon Regional Health Centre
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Winnipeg、Manitoba、カナダ
- Concordia Hospital
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Nova Scotia
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Halifax、Nova Scotia、カナダ
- Victoria General Hospital
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Ontario
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London、Ontario、カナダ
- London Health Sciences Centre
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Napanee、Ontario、カナダ
- Lennox Addington County General Hospital
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Niagara Falls、Ontario、カナダ
- Niagara Health Systems
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Thunder Bay、Ontario、カナダ
- Thunder Bay Regional Health Sciences Centre
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Saskatchewan
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Regina、Saskatchewan、カナダ
- Pasqua Hospital
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Patient on the study unit
Exclusion Criteria:
- patients not on the study unit
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：他の
- 時間の展望：見込みのある
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
|
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
|
|
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
|
|
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
|
|
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
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
success with implementation
時間枠：19 months
|
rates of screening, diagnosis and treatment with medication pass per month of the study
|
19 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Adverse events while in hospital (fall, new infection etc.)
時間枠：19 months
|
19 months
|
|
|
Length of stay
時間枠：19 months
|
Average length of stay for patients admitted to the study unit; monthly average
|
19 months
|
|
Readmission rate
時間枠：19 months
|
number of patients per month discharged and readmitted to the hospital within 30 days
|
19 months
|
協力者と研究者
スポンサー
捜査官
- 主任研究者：Heather Keller, PhD、University of Waterloo
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有サポート情報タイプ
- 分析コード
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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