Faculty of Applied Health Science, University of Waterloo, Waterloo, ON, Canada.
NNEdPro Global Centre for Nutrition and Health (affiliated with Cambridge University Health Partners, Wolfson College Cambridge, and the British Dietetic Association), St John's Innovation Centre, Cambridge, United Kingdom.
JPEN J Parenter Enteral Nutr. 2018 May;42(4):786-796. doi: 10.1177/0148607117718493. Epub 2017 Dec 19.
Staff play key roles in the prevention, detection, and treatment of hospital malnutrition. Understanding staff knowledge, attitudes, and practices (KAP) is important for developing and evaluating change management strategies.
The More-2-Eat project improved nutrition care in 5 Canadian hospitals by implementing the Integrated Nutrition Pathway for Acute Care (INPAC). To understand staff views before (T1) and after 1 year of implementation (T2), a reliable KAP questionnaire, based on INPAC, was administered. T2 included questions about involvement in implementation. The mean difference between T2 and T1 responses was calculated, and t tests were used for comparisons.
The questionnaire was completed at T1 (n = 189) and T2 (n = 147) (unpaired); 57 staff completed both questionnaires (paired). A significant increase in total score was seen in unpaired results at T2 (from 93.6/128 [range, 51-124] to 99.5/128 [range, 54-119]; t = 5.97, P < .0001), with an increase in knowledge/attitudes (KA) (t = 2.4, P = .016) and practice (t = 3.57, P < .0001) components. There were no statistically significant changes in paired responses. Seventy percent (n = 102/147) noticed positive changes in practices, 12% (n = 18) noticed positive/negative changes, 1% (n = 1) noticed negative change, and 17% (n = 25) noticed no change. Fifty-nine percent (n = 86) felt involved in the change, and these staff had higher KA and KAP scores than those who did not feel involved.
Staff involvement is important in the implementation process for improving nutrition care.
员工在预防、发现和治疗医院营养不良方面发挥着关键作用。了解员工的知识、态度和实践（KAP）对于制定和评估变革管理策略非常重要。
More-2-Eat 项目通过实施急性照护综合营养途径（INPAC），改善了加拿大 5 家医院的营养护理。为了了解实施前后（T1 和 T2）员工的看法，我们采用了基于 INPAC 的可靠 KAP 问卷进行调查。T2 包括了关于参与实施的问题。计算了 T2 与 T1 回答之间的平均差异，并进行了 t 检验。
T1（n = 189）和 T2（n = 147）时完成了问卷（非配对）；57 名员工完成了两份问卷（配对）。在非配对结果中，T2 的总分显著增加（从 93.6/128（范围：51-124）增至 99.5/128（范围：54-119）；t = 5.97，P <.0001），知识/态度（KA）（t = 2.4，P =.016）和实践（t = 3.57，P <.0001）两个方面都有所增加。配对结果无统计学意义的变化。70%（n = 102/147）注意到实践方面的积极变化，12%（n = 18）注意到积极/消极变化，1%（n = 1）注意到消极变化，17%（n = 25）注意到没有变化。59%（n = 86）感到参与了变革，这些员工的 KA 和 KAP 得分高于未参与的员工。
员工的参与对于改善营养护理的实施过程非常重要。
