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.
Обзор исследования
Статус
Условия
Вмешательство/лечение
Подробное описание
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.
Тип исследования
Регистрация (Действительный)
Контакты и местонахождение
Места учебы
-
-
Alberta
-
Edmonton, Alberta, Канада
- Royal Alexander Hospital
-
-
Manitoba
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Brandon, Manitoba, Канада
- Brandon Regional Health Centre
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Winnipeg, Manitoba, Канада
- Concordia Hospital
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-
Nova Scotia
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Halifax, Nova Scotia, Канада
- Victoria General Hospital
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-
Ontario
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London, Ontario, Канада
- London Health Sciences Centre
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Napanee, Ontario, Канада
- Lennox Addington County General Hospital
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Niagara Falls, Ontario, Канада
- Niagara Health Systems
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Thunder Bay, Ontario, Канада
- Thunder Bay Regional Health Sciences Centre
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Saskatchewan
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Regina, Saskatchewan, Канада
- Pasqua Hospital
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-
Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Метод выборки
Исследуемая популяция
Описание
Inclusion Criteria:
- Patient on the study unit
Exclusion Criteria:
- patients not on the study unit
Учебный план
Как устроено исследование?
Детали дизайна
- Наблюдательные модели: Другой
- Временные перспективы: Перспективный
Когорты и вмешательства
Группа / когорта |
Вмешательство/лечение |
|---|---|
|
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
|
Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
success with implementation
Временное ограничение: 19 months
|
rates of screening, diagnosis and treatment with medication pass per month of the study
|
19 months
|
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Adverse events while in hospital (fall, new infection etc.)
Временное ограничение: 19 months
|
19 months
|
|
|
Length of stay
Временное ограничение: 19 months
|
Average length of stay for patients admitted to the study unit; monthly average
|
19 months
|
|
Readmission rate
Временное ограничение: 19 months
|
number of patients per month discharged and readmitted to the hospital within 30 days
|
19 months
|
Соавторы и исследователи
Спонсор
Следователи
- Главный следователь: Heather Keller, PhD, University of Waterloo
Публикации и полезные ссылки
Даты записи исследования
Изучение основных дат
Начало исследования (Действительный)
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
Другие идентификационные номера исследования
- KT2017-01
Планирование данных отдельных участников (IPD)
Планируете делиться данными об отдельных участниках (IPD)?
Описание плана IPD
Сроки обмена IPD
Совместное использование IPD Поддерживающий тип информации
- Аналитический код
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
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