Development of a Nutrition Care Process implementation package for hospital dietetic departments

Abstract

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

The Nutrition Care Process Terminology: Changes in perceptions, attitudes, knowledge and implementation amongst Australian dietitians after three years

“…The validated ‘Attitudes, Support, Knowledge, of the Nutrition Care Process’ (ASK NCP) survey was utilised to gain insight into dietitians’ views regarding NCP and IDNT implementation . This survey has been shown to be valid and repeatable . The ASK NCP survey was completed electronically using ‘Survey Monkey’ (http://www.surveymonkey.com, Palo Alto, CA).…”

“…The framework is a four‐step process including nutrition assessment, diagnosis, intervention and monitoring and evaluation . Following the introduction of the NCP, a standardised language known as the International Dietetics and Nutrition Terminology (IDNT) was developed to provide dietitians with consistent terms to use throughout nutrition assessment, diagnosis, intervention and evaluation . The NCP and the IDNT are collectively referred to as the Nutrition Care Process Terminology (NCPT) …”

“…The NCPT aims to increase documentation consistency and allow the specific identification of nutrition issues in relation to, but set apart from, medical diagnoses. In addition, the terminology may provide clear and interpretable nutritional information to other allied health professions and allow for effective ongoing evaluation of health outcomes . Use of the NCPT is not mandatory for dietitians within Australia but is highly recommended by the Dietitians Association of Australia (DAA).…”

“…Whilst the reasoning behind the introduction of the NCPT is well described, evidence of perceived benefits and potential issues in practice is lacking. Consequently, a baseline survey was completed in 2011 to assess NCPT usage, knowledge and attitudes of those working in the profession . Following NCPT adoption within Australia, survey results identified issues for practice, including time for implementation of new procedures, and it is valuable to monitor how NCPT adoption progresses and how the changes affect those involved .…”

The accuracy and consistency of nutrition care process terminology use in cases of refeeding syndrome

“…However, there is limited literature as to whether implementation has been successful within these countries. Dietitian nutritionists in the United States of America (USA) remain the highest users of NCPT, with the majority of research focused around its use within American practice …”