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  • Early oral feeding after colorectal surgery: A mixed methods study of knowledge translation

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    RobertsonPUB6263.pdf (308.0Kb)
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    Accepted Manuscript (AM)
    Author(s)
    Robertson, Tayla R
    Eldridge, Naomi E
    Rattray, Megan E
    Roberts, Shelley
    Desbrow, Ben
    Marshall, Andrea P
    Ali, Azmat B
    Hickman, Ingrid J
    Griffith University Author(s)
    Desbrow, Ben
    Roberts, Shelley J.
    Marshall, Andrea
    Year published
    2018
    Metadata
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    Abstract
    Aim: Evidence-based guidelines recommend early oral feeding (EOF) as prescription of an unrestricted diet within 24 hours after colorectal surgery. The present study aimed to understand local postoperative feeding practices after colorectal surgery; identify barriers to EOF implementation; select, tailor and implement stakeholder engagement strategies to facilitate EOF uptake; and evaluate changes to practice. Methods: A longitudinal, mixed methods study was undertaken, guided by the knowledge-to-action framework. Phase 1 assessed the nature of the problem using postoperative diet Audits 1 and 2. In Phase 2, staff interviews ...
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    Aim: Evidence-based guidelines recommend early oral feeding (EOF) as prescription of an unrestricted diet within 24 hours after colorectal surgery. The present study aimed to understand local postoperative feeding practices after colorectal surgery; identify barriers to EOF implementation; select, tailor and implement stakeholder engagement strategies to facilitate EOF uptake; and evaluate changes to practice. Methods: A longitudinal, mixed methods study was undertaken, guided by the knowledge-to-action framework. Phase 1 assessed the nature of the problem using postoperative diet Audits 1 and 2. In Phase 2, staff interviews identified barriers to EOF implementation. Results from Phases 1 and 2 were fed back to inform Phase 3 strategies. Knowledge uptake was monitored in Audits 3 and 4. Phase 4 evaluated outcomes from Audit 5. Results: In Phase 1, median time to commencement of full diet was postoperative Days 4 and 3 in Audits 1 and 2, respectively. Phase 2 identified EOF barriers, including disparities in diet upgrade practices and variable understanding of hospital diets. In Phase 3, planned strategies were implemented to improve EOF (i) educational session describing local hospital diets; (ii) consultant decision to prescribe a full diet on operation notes; and (iii) educational sessions with nursing staff describing changes to EOF practice. In Phase 4, median time to commencement of full diet improved to postoperative Day 0. Patients prescribed a full diet on operation notes increased from 0% to 82%. Conclusions: The present study successfully identified and overcame local barriers to improve EOF practices to align with guideline recommendations.
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    Journal Title
    Nutrition & Dietetics
    Volume
    75
    Issue
    4
    Publisher URI
    https://onlinelibrary.wiley.com/doi/full/10.1111/1747-0080.12473
    DOI
    https://doi.org/10.1111/1747-0080.12473
    Copyright Statement
    © 2018 Dietitians Association of Australia. This is the peer reviewed version of the following article: Early oral feeding after colorectal surgery: A mixedmethods study of knowledge translation, Nutrition & Dietetics, Vol. 75: pp. 345–352, 2018, which has been published in final form at 10.1111/1747-0080.12473. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
    Subject
    Nutrition and dietetics
    Health services and systems
    Public health
    Food sciences
    Clinical nutrition
    Early oral feeding
    Enhanced recovery after surgery
    Postoperative care
    Publication URI
    http://hdl.handle.net/10072/382541
    Collection
    • Journal articles

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