care using technology: The NUTRI-TEC study Dr Shelley Roberts PhD, - - PowerPoint PPT Presentation
Engaging patients in their nutrition care using technology: The NUTRI-TEC study Dr Shelley Roberts PhD, Accredited Practicing Dietitian Allied Health Research Fellow Griffith University and Gold Coast Health Prof Andrea Marshall, Prof Wendy
PhD, Accredited Practicing Dietitian
Allied Health Research Fellow Griffith University and Gold Coast Health
Prof Andrea Marshall, Prof Wendy Chaboyer, Dr Merrilyn Banks, A/Prof Ben Desbrow, Zane Hopper, Alan Spencer, Ruben Gonzalez
Hospital malnutrition: prevalence, causes, effects, interventions (incl. patient participation) Dietary intakes of hospitalised patients and nutrition care practices (in study context)16,17 Patients’ perceptions of actively participating in their nutrition care18 Theory and data informed (self-efficacy, patient participation in care, self-monitoring, goal setting) Determining feasibility, acceptability, indication of effectiveness (paper materials)11
KNOWLEDGE TO ACTION (K2A) FRAMEWORK
Graham, Ian D., et al. "Lost in knowledge translation: time for a map?." Journal of continuing education in the health professions 26.1 (2006): 13-24.
Realist review: Using technology to engage hospitalised patients in their care19 Usability: user interface design and functionality20 Patient and staff perceptions of using this technology to participate in nutrition care20,21 Co-development with end-users (staff, patients) and industry partner (Delegate Technology) Determining feasibility, acceptability, indication of effectiveness (tech-based)
USABILITY TESTING & PATIENT INTERVIEWS (n=32)
1. Familiarity with technology not necessary, but improves confidence
“I’m not any good with a computer because I haven’t even got one, but if I can navigate my way through that then anyone can.” (P18, age 66)
2. User interface design significantly impacts usability (wording, display, navigation, instructions) “It wasn’t difficult, it was just frustrating…. It’s the way it’s set
3. Identifying benefits to technology increases its acceptance (efficiency, flexibility, individualised) “The best thing about it, it’s instantaneous, you can’t lose the
piece of paper…and the order goes straight to the kitchen…it’s very easy to do.” (P9, age 61)
4. Technology enables participation, which occurs to varying extents (information access, communicating with staff, personal factors)
“If patients knew exactly what was in the meals and what they were ordering exactly then they’d maybe make different decisions of what they were going to order in the first place.” (P14, age 32)
5. Degree of participation depends on perceived importance of nutrition (personal interest/relevance, level of control / responsibility of nutrition in hospital) “I’m just not that interested in those specifics…In fact thinking about it, my wife
would find real interest in that. She’s really interested in those sorts of things – I’m not, because she looks after me.” (P24, age 63)
STAFF INTERVIEWS (n=19)
1. Enacting patient participation in practice
“…the existing food chart is filled by nurses and sometimes we get patients involved as part of helping them to become good self-managers, involved in completing their food chart.” (Dietitian)
2. Optimising nutrition care
“It would be a lot easier to look at that [intake tracking] than a food chart. Also,
then that might be a better prospect.” (Doctor)
3. Considerations for implementing the program in practice
“I would say there definitely would be a percentage [of patients] that would find it difficult to fill them in. But I think the nursing staff could certainly assist in those cases if we are already filling in a food chart anyway.” (Nurse)
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19. Roberts S, Chaboyer W, Gonzalez R, Marshall A. Using technology to engage hospitalised patients in their care: a realist review. BMC health services research. 2017 Dec;17(1):388. 20. Roberts, S., et al., Technology to engage hospitalised patients in their nutrition care: a qualitative study of usability and patient perceptions of an electronic foodservice system. Journal of Human Nutrition and Dietetics, 2017;30(5)563-573. 21. Roberts, S., A. Marshall, and W. Chaboyer, Hospital staff's perceptions of an electronic program to engage patients in nutrition care at the bedside: a qualitative study. BMC Medical Informatics and Decision Making, 2017;17(1):105.
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