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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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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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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
- Patient on the study unit
Exclusion Criteria:
- patients not on the study unit
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: Ander
- Tijdsperspectieven: Prospectief
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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Royal Alexandria
Administrative records
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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
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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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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
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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
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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 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
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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
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Hospital 9
Administrative Records
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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
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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success with implementation
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Adverse events while in hospital (fall, new infection etc.)
Tijdsspanne: 19 months
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19 months
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Length of stay
Tijdsspanne: 19 months
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Average length of stay for patients admitted to the study unit; monthly average
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19 months
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Readmission rate
Tijdsspanne: 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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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Heather Keller, PhD, University of Waterloo
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- KT2017-01
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD delen Ondersteunend informatietype
- Analytische code
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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