Background Nutrition and mealtime interventions can improve nutritional intake amongst hospital inpatients; however, patient‐reported experience is rarely considered in their development and evaluation. The present study aimed to measure patient‐reported food and mealtime experience to evaluate and inform continuous quality improvement of hospital nutrition care. Methods A cross‐sectional survey with inpatients in seven acute care and rehabilitation wards was conducted. A 27‐item validated questionnaire measured five domains of patient experience: food choices, organisational barriers, feeling hungry, physical barriers to eating and food quality. Responses were summarised descriptively and compared between settings (acute versus rehabilitation), patient demographics (age, gender) and time in hospital. Results Responses from 143 participants (mean age 67 years, 57% male, 28% rehabilitation, median 6 days into hospitalisation) showed that 10% or fewer respondents reported difficulties with food choices, feeling hungry or food quality. The most common difficulties were opening packets (36%), insufficient menu information provided (29%), being interrupted by staff when eating (28%), being disturbed when eating (27%), being in an uncomfortable position when eating (24%) and difficulty reaching food (21%). There were no significant differences in domain patterns by sex, age group or time in hospital. Organisational barriers were reported less frequently amongst rehabilitation participants compared to acute care (P = 0.01). Conclusions This survey highlights areas of positive patient‐reported experience with nutrition care and suggests that local improvement efforts should focus on physical assistance needs and organisational barriers, especially in acute care wards. The questionnaire may be useful for informing and evaluating systematic nutrition care improvements.
Purpose: Knowledge translation (KT) in the health system is critical for the delivery of evidence-based practice. Supporting allied health professionals to plan and implement KT, using strategies that broadly reach across multiple geographical locations of the workforce, are needed. We piloted KT group telementoring via videoconference as an innovative solution to support and empower a vastly dispersed workforce. Methods: The 6-month Knowledge Translation Support Service (KTSS) involved monthly, one-hour, virtual group-based support of clinician-led KT projects within state-run hospital and health services. Supported by an independent facilitator, a panel of KT experts and health service leaders provided constructive critique and KT support for four projects from various disciplines (dietetics, nursing, occupational therapy, physiotherapy and social work) and health districts. Process evaluation included an assessment of program fidelity, dose delivered and engagement. Program acceptability (participants and panel members) was assessed after each session through online surveys. Effectiveness was captured by survey of KT confidence and qualitative interviews of participants perceived benefits of participation. Results: All project leads attended each meeting, with 1-2 specific projects discussed each month. On completion, participants reported high program satisfaction and felt that the KTSS met their expectations and learning needs. Overall the participants described beneficial gains with confidence in KT skills. Conclusions: The telementoring offered exposure to a breadth of expertise not normally accessible, successfully built a team environment in the virtual space and had a positive impact on project progression. Future directions include investing in scalability and sustainability of telementoring strategies for KT support.
Background The COVID-19 pandemic has significantly impacted the delivery of diabetes in pregnancy care and general maternity care. This study aimed to explore the experiences and acceptability of telehealth use in diabetes in pregnancy care during the COVID-19 pandemic, from the perspectives of pregnant women and their clinicians. The secondary aim was to explore the experiences of pregnant women receiving general maternity care via telehealth during the COVID-19 pandemic. Methods In-depth qualitative semi-structured interviews were undertaken and analysed via thematic inductive approaches. The Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies Framework (NASSS) was applied. Results Eigthteen interviews were conducted with culturally and linguistically diverse pregnant women and 4 clinicians (endocrinologists and dietitians). All interviewees were satisfied with telehealth as a positive alternative to face-to-face consultations for diabetes care during the COVID-19 pandemic. Numerous benefits of delivering diabetes care via telehealth were discussed and themes centred around greater access to care, economic benefits and improved safety. Most barriers concerned the adopters (clinicians), yet, feasible and realistic suggestions to overcome barriers were voiced. The scope for technology adaptation and ongoing embedment into routine diabetes care was described. Overall, a hybrid flexible delivery model, predominantly consisting of telephone consultations, with some face-to-face consultations for initial diabetes appointments was recommended for future care. The use of telehealth in replacement of face-to-face appointments for general maternity care was perceived as reducing care quality. Conclusion In this study, telehealth was viewed as acceptable to women and clinicians for diabetes in pregnancy care, supporting the ongoing delivery of a hybrid service model of telehealth and face-to-face care. These findings provide valuable information to improve diabetes in pregnancy services to meet the needs of women during the COVID-19 pandemic and beyond.
Objectives: To understand the motivation of older rehabilitation inpatients for mobilisation, and identify barriers and enablers to greater mobilisation. Methods: Qualitative semi-structured interviews were conducted with older rehabilitation inpatients. All interviews were audio-taped, transcribed verbatim and analysed using thematic and inductive techniques. Results: From 23 interviews, we found that older patients strongly value mobilisation during rehabilitation admission, to get better and maintain identity, personhood and meaningful connections. At the patient level, mobilisation was impacted by patient's confidence, family support and symptom management. At the organisational level, barriers to mobilisation included lack of timely staff support, inflexible routines, limited social opportunities, lack of physical resources, and poor communication. Conclusions: Recognising and understanding motivators, enablers and barriers to mobilising during subacute hospitalisation of older patients is an essential step towards developing and implementing successful strategies to promote greater mobilisation. Addressing mobilisation barriers requires a multifaceted approach at the patient and organisational level.
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