Aim: Information on attitudes and knowledge of practising dietitians regarding the Nutrition Care Process (NCP) and International Dietetics and Nutrition Terminology (IDNT) would be useful to inform effective implementation. The present study aimed to: (i) explore dietitians\u27 expectations, perceptions and anticipated benefits of NCP/IDNT pre and post implementation; (ii) identify perceived implementation barriers and enablers; and (iii) develop and assess a train-the-trainer NCP/IDNT implementation approach. Methods: All Queensland Government State hospitals from metropolitan, regional and remote areas were included in the study. Dietitian champions (n = 17) attended one face-to-face, train-the-trainer day, then led 14 one-hour educational sessions to 279 district dietitians tailored to local situations, facilities and resources. NCP/IDNT were embedded into local processes and chart audits completed. Pre-/post-implementation surveys were completed by 86 dietitians. Results: Pre-implementation results showed positive attitudes regarding the value of NCP/IDNT (mean 1.89, SD 0.67, 1 = strongly agree, 5 = strongly disagree). Dietitians identified management support; practice, tutorials and workshops; mentor support; and follow up audits as important for successful implementation. Most attendees (81%) completed ≥10/13 tutorials and 86% (415/480) of audited charts included Nutritional Diagnosis statements. Post-implementation familiarity, confidence and knowledge of NCPT (Nutrition Care Process Terminology) significantly improved (P \u3c 0.001). Conclusions: Prior to implementation, respondents viewed the NCP/IDNT as applicable to their practice areas. The train-the-trainer program with frequent teleconference and email support was effective in improving knowledge, confidence, preparedness for implementing NCPT and charting behaviour. Although training was positively received and has achieved good results, dietitians identified the need for ongoing training and support to further increase confidence following implementation

Aim: The Academy of Nutrition and Dietetics has led the development and dissemination of the Nutrition Care Process (NCP), incorporating the Nutrition Care Process Terminology as the standardised language. This research investigates and compares the views of Australian dietitians pre and post NCP implementation to inform development of an NCP implementation package. Methods: Dietitians from two hospitals that had undergone informal NCP implementation (post-implementers, n = 35) and three hospitals yet to implement NCP (pre-implementers, n = 35) completed an online questionnaire (ASK NCP) surveying demographics and constructs relating to knowledge, familiarity, confidence, support, value, barriers, training and NCP education. Results: Post-implementers had higher knowledge scores (P \u3c 0.05), were more familiar with NCP (P \u3c 0.01), confident to implement (P \u3c 0.01) and supported to use NCP (P \u3c 0.01) than pre-implementers. Lack of knowledge, support, training and resources was identified as a barrier by pre-implementers. Busy workloads and work status were identified as barriers by post-implementers. Pre-implementers felt they had insufficient NCP training; however, if further training and support were to be provided, almost all reported they would be more confident to implement. Keys to successful implementation included allocated time to practice and regular tutorials; support and leadership from their management and NCP department leader; and professional growth through understanding how change could benefit practice. Conclusions: The results of the study were used to inform the development of an NCP implementation package. Kotter\u27s eight stages of change were identified as the most appropriate change management model with the framework incorporated into the package development

Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment.

Aim: Incorporation of the Nutrition Care Process (NCP) and NCP Terminology (NCPt) into clinical dietetics practice is advocated in Australia; however, no evidence-based implementation process exists, which may hinder uptake. Based on formative research findings from the Attitudes Skill Knowledge (ASK) NCP survey and using a change management framework, we developed an implementation package for Australian hospital dietitians. This paper aims to report on the outcome of the pilot evaluation and efficacy of the package. Methods: Dietitians from three hospitals (two tests and one control) in Western Australia who had not undergone NCP implementation were recruited. Evaluation occurred through administering the ASK NCP survey pre and post implementation in all subjects and focus groups at test sites. The Mann-Whitney U-test was applied to determine whether the changes in the test group were significantly different to the control group. The Wilcoxon signed rank test was used to determine whether there were significant changes within groups. Focus groups were audio-recorded, transcribed and then analysed for themes by the authors. Results: Compared to pre-implementation, the dietitians from the test hospitals had significantly higher NCP knowledge (P = 0.006), were more familiar with NCP (P = 0.01) and NCPt (P = 0.025), and more confident to utilise NCP practice (P = 0.011). Compared to pre-implementation, the control group displayed significantly higher familiarity with NCP and NCPt (P = 0.041); however, significant improvements in other constructs were not observed. No significant difference was observed between groups for all constructs. Conclusions: Dietitians found the package useful and would recommend it to Australian hospital dietetic departments

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