Towards a nationwide implementation of a standardized nutrition and dietetics terminology in clinical practice: a pre-implementation focus group study including a pretest and using the consolidated framework for implementation research

Abstract

Background & AimsIn order to assure high quality of nutrition and dietetic care as well as research, the implementation of a standardized terminology, such as the World Health Organization (WHO) International Classification of Functioning, Disability and Health for Dietetics (ICF-Dietetics) is indispensable. The aim of this study was to explore the clinical practicability and applicability of the ICF-Dietetics in the field of nutrition and dietetic practice prior to the implementation in order to develop criteria (points to consider) for a targeted implementation strategy.MethodsA focus group study including a pretest of the ICF-Dietetics was conducted. Subsequently, facilitators and barriers for a nationwide implementation of the ICF-Dietetics in clinical nutrition and dietetic practice were identified and linked to interventions (combining theory-based and group-based approach) using the Consolidated Framework of Implementation Research (CFIR) to organize and represent data and summarized in a logic model.ResultsIn the pretest 55 clinical documentations which consisted of 248 different ICF-Dietetics categories were received. In four focus groups with 22 health professionals, 66 relevant higher-level themes and implementation strategy criteria (points to consider) were identified. These themes referred to all five domains of the CFIR, namely intervention characteristics, inner setting, outer setting, characteristics of individuals and implementation process and contained important barriers and facilitators that were linked to six implementation objectives as well as six context requirements and five main actors.ConclusionsThis study provides facilitators and barriers to be addressed when implementing the ICF-Dietetics in clinical practice and shows potential interventions based on this analysis. A nationwide implementation was mainly seen as a great advantage for enhancing quality and continuity of care and for providing comparable data. However, it requires further refinements and a multifaceted implementation strategy where the engagement of leadership of institutions plays a crucial role. These results have provided a foundation for a targeted implementation strategy to increase the success, reproducibility and comparability.

Effectiveness of a culturally competent care intervention in reducing disparities in Hispanic live donor kidney transplantation: A hybrid trial

“…Resources currently available to help translate our research to the real‐world setting include the published study protocol, 29 which describes HKTP components in detail; scripts, protocols, and other materials will be made available in an online repository. Intervention complexity is a major barrier to implementing interventions 52 . It took 6–9 months to prepare to launch the first HKTP education session.…”

“…complexity is a major barrier to implementing interventions. 52 It took 6-9 months to prepare to launch the first HKTP education session.…”

Rehabilitation nutrition for individuals with frailty, disability, sarcopenic dysphagia, or sarcopenic respiratory disability

“…However, the ICF-Dietetics is used in only 7 out of 56 (12.5%) hospitals in Jeddah, Saudi Arabia [ 30 ] and is not used in most hospitals in Japan. A qualitative study of the ICF-Dietetics addressed six implementation objectives: (1) provide information to other professional groups, (2) provide training on the ICF-Dietetics coding system, (3) integrate the ICF-Dietetics into an electronic health information system, (4) apply the ICF-Dietetics for goal setting and evaluation, (5) establish a learning environment, and (6) define individual goals for change [ 31 ]. Both rehabilitation nutritional care and the ICF-Dietetics should be used more widely in clinical practice.…”

Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment

“…Document templates were developed alongside this for the DCP, based on ICF documentation tools [ 13 , 53 ]. A multicentre study [ 50 ] and a focus group study [ 54 ] showed that the integration of the ICF-Dietetics into the DCP was possible, and an Austria-wide implementation of the ICF-Dietetics was advocated. However, a multifaceted implementation strategy is required, with the integration of ICF-Dietetics into existing health information systems (HIS) seen as a prerequisite for a successful implementation [ 54 ].…”