Engaging hospitalised patients in their nutrition care using technology: development of the NUTRI-TEC intervention

Abstract

Background: Nutrition is vital for health and recovery during hospitalisation, however most patients fail to meet minimum dietary requirements and up to 50% of patients are malnourished in hospital. When patients participate in nutrition care, their dietary intakes are improved. Advances in health information technology (HIT) have broadened the ways by which patients can participate in care. Our team has developed an innovative, HIT-based intervention (called NUTRI-TEC; engaging patients in their nutrition care using technology), facilitating patient participation in their nutrition care in hospital. This paper aims to describe the systematic and iterative process by which the intervention was developed. Methods: NUTRI-TEC development was informed by the Medical Research Council guidance for developing complex interventions and underpinned by theoretical frameworks and concepts (i.e. integrated knowledge translation and patient participation in care), existing evidence and a rigorous program of research. The intervention was co-developed by the multidisciplinary research team and stakeholders, including health consumers (patients), health professionals and industry partners. We used an iterative development and evaluation cycle and regularly tested the intervention with hospital patients and clinicians. Results: The NUTRI-TEC intervention involves active patient participation in their nutrition care during hospitalisation. It has two components: 1) Patient education and training; and 2) Guided nutrition goal setting and patient-generated dietary intake tracking. The first component includes brief education on the importance of meeting energy/protein requirements in hospital; and training on how to use the hospital's electronic foodservice system, accessed via bedside computer screens. The second component involves patients recording their food intake after each meal on their bedside computer and tracking their intakes relative to their goals. This is supported with brief, daily goal-setting sessions with a health care professional.

Hospital patients' perceptions of using a technology-based intervention to participate in their nutrition care: A qualitative descriptive study

“…Our team developed an intervention to engage patients in their nutrition care whilst in hospital, through self-monitoring of dietary intake and participation in guided nutrition goal setting (8,13). When piloted in paper format (using paper food charts and printed nutritional goals pages), patients were very accepting of the intervention and reported: having an increased awareness of nutrition; feeling encouraged and motivated to eat more; and feeling responsible for their own nutrition in hospital.…”

Investigating differences between traditional (paper bag) ordering and online ordering from primary school canteens: a cross-sectional study comparing menu, usage and lunch order characteristics

“…Evidence from large population studies suggests a rapid increase in the use of online systems to order and access food. These systems are also now available in hospitals (35,36) , workplaces (37) , schools (14,16) and of course foods to be delivered to the home (e.g. take-away (38) .…”

Using Technology to Promote Patient Engagement in Nutrition Care: A Feasibility Study

“…If patients met <75% of their estimated energy/protein requirements on a given day, RAs reviewed possible strategies that patients could enact to help meet their requirements. A detailed description of intervention components and development can be found in a separate publication [29]. for each meal item, presented in quartiles (see Figure 1).…”

“…If patients met <75% of their estimated energy/protein requirements on a given day, RAs reviewed possible strategies that patients could enact to help meet their requirements. A detailed description of intervention components and development can be found in a separate publication [29]. The intervention also included review sessions conducted by RAs (daily for the first week after enrolment and every second day for the second week after enrolment) to engage patients in guided nutritional goal setting and monitoring via the EFS.…”