Designing complex interventions to translate research into practice: A rare but important opportunity for nutrition care — ASN Events
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Designing complex interventions to translate research into practice: A rare but important opportunity for nutrition care (#126)

Merran Findlay 1 2 3 , Tim Shaw 3 4 , Judith Bauer 5 , Nicole Rankin 3 , Michael Boyer 2 3 , Chris Milross 2 3 , Kate White 3 6 , Philip Beale 3 7
  1. The Daffodil Centre, The University of Sydney - a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  2. Chris O'Brien Lifehouse, Sydney, NSW, Australia
  3. Maridulu Budyari Gumal (SPHERE) Cancer Clinical Academic Group, University of NSW, Sydney, NSW, Australia
  4. Research in Implementation Science and eHealth (RISe), Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
  5. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
  6. Cancer Care Research Unit, Susak Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
  7. Cancer Services, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia

Aims

Malnutrition is prevalent in patients with head and neck cancer (HNC) impacting on outcomes. Despite publication of evidence-based nutrition guidelines (EBGs), evidence-practice gaps remain. Reasons include lack of familiarity with the EBGs amongst the multidisciplinary team (MDT), dietetic resource and infrastructure limitations and lack of awareness of the intensiveness of nutrition care required. This project aims to implement and evaluate a best-practice dietetic model of care (MOC). Through integration with the MDT, the MOC will take a patient-centred approach to minimise the detrimental sequelae of malnutrition. 

Methods

A mixed methods, pre-post study design will be used to inform the new MOC to be implemented and evaluate outcomes of interest across three phases of pre-implementation, implementation and post-implementation. Qualitative interviews will be conducted with patients and health professionals to identify barriers and incentives to change. A medical record audit will establish baseline adherence to best practice recommendations and clinical parameters. A series of surveys prior to and post implementation will record staff knowledge, attitudes and opinions of the EBG recommendations. This systematic approach to effective knowledge translation will engage with clinical teams to prioritise aspects of the MOC to be implemented.

Planned Analysis

Primary outcomes of interest include process measures (adherence to new appointment schedules and screening/assessment protocols) and clinical outcomes (effect of the new MOC on nutritional outcome measures and quality of life). Secondary process (clinician awareness, knowledge and acceptance of EBGs) and clinical outcomes (nutrition and hydration-related hospital admissions, length of stay, duration of feeding tube use and influence on treatment completion rates) will be monitored. A preliminary cost-effectiveness analysis will inform future sustainability strategies.

Conclusions

The level of evidence provides justification for the highly feasible translation to an evidence-based dietetic MOC to improve patient outcomes that will facilitate uptake of best practice nutrition care across broader settings.

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