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dc.contributor.authorMackay, HJ
dc.contributor.authorCampbell, KL
dc.contributor.authorvan der Meij, BS
dc.contributor.authorWilkinson, SA
dc.date.accessioned2019-06-15T12:31:01Z
dc.date.available2019-06-15T12:31:01Z
dc.date.issued2019
dc.identifier.issn1446-6368
dc.identifier.doi10.1111/1747-0080.12528
dc.identifier.urihttp://hdl.handle.net/10072/384510
dc.description.abstractAim: To establish an evidence-based dietetics service in an in-centre haemodialysis unit utilising implementation science. Methods: The service was developed through the Knowledge-to-Action Framework. The steps of the Action Cycle were addressed through a literature review, identification of evidence-based guidelines, benchmarking and local staff engagement. The theoretical domains framework (TDF) was used to identify barriers/enablers, and behaviour change wheel to determine appropriate interventions. To monitor, evaluate outcomes and assess sustained knowledge use we employed multidisciplinary team engagement and database use. Audit data were collected at baseline, 6 and 12 months on nutrition assessment (Patient-Generated Subjective Global Assessment), intervention timeliness and alignment to dietetic workforce recommendations. Descriptive statistics, McNemar tests and a linear mixed model were applied. Results: Barriers existed in the knowledge, skills, environmental context and resources TDF domains. Suitable interventions were identified with training on nutritional management of haemodialysis patients delivered to 148 nurses, and nutrition management recommendations summarised into local procedural resources. A database to prompt and monitor outcome measures was created and indicated that over 18 months post-service commencement, eligible patients received nutrition assessment at least 6-monthly, aligning with recommendations. Prevalence of malnutrition was 28% (n = 9/32) at baseline, 23% (n = 5/22) at 6 months and 20% (n = 4/20) at 12 months (P = 0.50). Conclusions: We demonstrated benefits to service development and implementation with implementation science providing a structured and methodical approach to translating guidelines into practice. Development of training, resources and prompts for outcome measures has supported the establishment of an evidence-based dietetics service in a haemodialysis unit.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.relation.ispartofpagefrom150
dc.relation.ispartofpageto157
dc.relation.ispartofissue2
dc.relation.ispartofjournalNutrition and Dietetics
dc.relation.ispartofvolume76
dc.subject.fieldofresearchFood Sciences
dc.subject.fieldofresearchNutrition and Dietetics
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode0908
dc.subject.fieldofresearchcode1111
dc.subject.fieldofresearchcode1117
dc.titleEstablishing an evidenced-based dietetic model of care in haemodialysis using implementation science
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorCampbell, Katrina


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