Prospective application of an implementation framework to improve postoperative nutrition care processes: Evaluation of a mixed methods implementation study

Nutrition & Dietetics : the Journal of the Dietitians Association of Australia
Angela ByrnesJudy Bauer

Abstract

To describe prospective application of an implementation framework to guide and evaluate a quality improvement (QI) project to improve adherence to evidence-based postoperative diet guidelines (consistent with Enhanced Recovery After Surgery, ERAS) in older surgical patients. A hybrid mixed methods study guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used. A pre-implementation audit identified gaps in nutrition-related care practices against ERAS guidelines for older surgical patients. Qualitative interviews explored barriers to practice change, informing development of the facilitated implementation strategy. Iterative facilitation interventions were identified by field notes and classified using i-PARIHS facilitator's tool-kit. Post-implementation audit measured implementation outcomes, and clinical processes and outcomes using controlled before-after comparative study. Implementation involved 17 discrete facilitation activities. Early postoperative diet upgrade was acceptable, well adopted (79%) and appropriate for 89% of patients. Fidelity (i.e. protocol delivered as intended) was 59%, with loss of fidelity primarily because of incorrect diet codes. Clinical ...Continue Reading

References

Feb 13, 2004·Health Technology Assessment : HTA·J M GrimshawC Donaldson
Mar 20, 2004·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·M Hickson, G Frost
Feb 5, 2005·Quality & Safety in Health Care·S MichieUNKNOWN "Psychological Theory" Group
May 15, 2007·Implementation Science : IS·David S ThompsonLars Wallin
Oct 1, 2008·BMJ : British Medical Journal·Peter CraigUNKNOWN Medical Research Council Guidance
May 23, 2009·Implementation Science : IS·Carl R MayVictor M Montori
Sep 25, 2010·Journal of the American Geriatrics Society·Vineet M AroraDavid O Meltzer
Oct 20, 2010·Administration and Policy in Mental Health·Enola ProctorMelissa Hensley
Jan 6, 2012·Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation·Emma J Hall-McMahon, Katrina L Campbell
Jul 27, 2012·Implementation Science : IS·Shannon D ScottDonna M Dryden
Jul 6, 2013·Calcified Tissue International·René RizzoliOlivier Bruyère
Sep 21, 2013·BMC Medical Research Methodology·Nicola K GaleSabi Redwood
Dec 18, 2013·International Journal of Colorectal Disease·Luca GianottiMarco Braga
Feb 15, 2014·World Journal of Clinical Cases·Federico GobbiZeno Bisoffi
Jun 20, 2014·International Journal of Evidence-based Healthcare·Elizabeth J DoghertyLisa Keeping-Burke
Aug 26, 2014·World Journal of Surgery·F GillissenM F von Meyenfeldt
Dec 17, 2014·BMC Health Services Research·Stephanie M C AmentTrudy van der Weijden
Jan 20, 2015·Journal of the American Geriatrics Society·Anna ZisbergGary Sinoff
Mar 21, 2015·BMJ : British Medical Journal·Graham F MooreJanis Baird
Dec 3, 2015·Worldviews on Evidence-based Nursing·Gill Harvey, Elizabeth McInnes
Jan 18, 2017·JAMA Surgery·Olle LjungqvistKenneth C Fearon
Apr 8, 2017·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Arved WeimannPierre Singer
Apr 21, 2017·Journal of Evaluation in Clinical Practice·Stephanie M C AmentTrudy van der Weijden

❮ Previous
Next ❯

Citations

Sep 13, 2019·Canadian Journal of Dietetic Practice and Research : a Publication of Dietitians of Canada = Revue Canadienne De La Pratique Et De La Recherche En Diététique : Une Publication Des Diététistes Du Canada·Adrienne M YoungIngrid Hickman
Aug 28, 2019·Surgical Endoscopy·Thomas A AloiaTonia M Young-Fadok
Mar 1, 2019·Journal of Nursing Care Quality·Michelle Barakat-JohnsonKathryn White
Nov 26, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Heather H KellerManon Laporte
Oct 21, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Heather KellerJack Bell
Jun 30, 2021·Nutrition & Dietetics : the Journal of the Dietitians Association of Australia·Adrienne M YoungShelley A Wilkinson
Jul 10, 2021·Journal of Advanced Nursing·Marguerite de FoubertCorina Naughton

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cell Aging (Keystone)

This feed focuses on cellular aging with emphasis on the mitochondria, autophagy, and metabolic processes associated with aging and longevity. Here is the latest research on cell aging.