Moick S, Hiesmayr M, Mouhieddine M, Kiss N, Bauer P, Sulz I, Singer P, Simon J
nutritionDay worldwide, Höfergasse 13/5, Vienna, 1090, Austria.
Department Cardiac-, Thoracic-, Vascular Anaesthesia and Intensive Care and CEMSIIS, Medical University Vienna, Vienna, A-1090, Austria.
Clin Nutr. 2021 Mar;40(3):936-945. doi: 10.1016/j.clnu.2020.06.021. Epub 2020 Jul 2.
BACKGROUND & AIMS: In hospital nutrition care the difficulty of translating knowledge to action often leads to inadequate management of patients with malnutrition. nutritionDay, an annual cross-sectional survey has been assessing nutrition care in healthcare institutions in 66 countries since 2006. While initial efforts led to increased awareness of malnutrition, specific local remedial actions rarely followed. Thus, reducing the Knowledge-to-action (KTA) gap in nutrition care requires more robust and focused strategies. This study describes the strategy, methods, instruments and experience of developing and implementing nutritionDay 2.0, an audit and feedback intervention that uses quality and economic indicators, feedback, benchmarking and self-defined action strategies to reduce the KTA gap in hospital nutrition care.
We used an evidence based multi-professional mixed-methods approach to develop and implement nutritionDay 2.0 This audit and feedback intervention is driven by a Knowledge-to-Action framework complemented with robust stakeholder analysis. Further evidence was synthesized from the literature, online surveys, a pilot study, World Cafés and individual expert feedback involving international health care professionals, nutrition care scientists and patients.
The process of developing and implementing nutritionDay 2.0 over three years resulted in a new audit questionnaire based on 36 nutrition care quality and economic indicators at hospital, unit and patient levels, a new action-oriented feedback and benchmarking report and a unit-level personalizable action plan template. The evaluation of nutritionDay 2.0 is ongoing and will include satisfaction and utility of nutritionDay 2.0 tools and short-, mid- and long-term effects on the KTA gap.
In clinical practice, nutritionDay 2.0 has the potential to promote behavioural and practice changes and improve hospital nutrition care outcomes. In research, the data generated advances knowledge about institutional malnutrition and quality of hospital nutrition care. The ongoing evaluation of the initiative will reveal how far the KTA gap in hospital nutrition care was addressed and facilitate the understanding of the mechanisms needed for successful audit and feedback.
Registration in clinicaltrials.gov: Identifier: NCT02820246.
在医院营养护理中，将知识转化为行动的困难常常导致营养不良患者的管理不足。自2006年以来，“营养日”这一年度横断面调查一直在评估66个国家医疗机构中的营养护理情况。虽然最初的努力提高了对营养不良的认识，但很少随之采取具体的地方补救行动。因此，缩小营养护理中的知识到行动（KTA）差距需要更有力、更有针对性的策略。本研究描述了开发和实施“营养日2.0”的策略、方法、工具和经验，这是一种审计与反馈干预措施，利用质量和经济指标、反馈、基准比较和自行制定的行动策略来缩小医院营养护理中的KTA差距。
我们采用基于证据的多专业混合方法来开发和实施“营养日2.0”。这种审计与反馈干预由一个知识到行动框架驱动，并辅以深入的利益相关者分析。通过文献、在线调查、一项试点研究、世界咖啡馆讨论以及涉及国际医疗保健专业人员、营养护理科学家和患者的个人专家反馈，综合获取了更多证据。
历经三年开发和实施“营养日2.0”的过程，产生了一份基于医院、科室和患者层面36项营养护理质量和经济指标的新审计问卷、一份新的面向行动的反馈与基准比较报告以及一个科室层面的可个性化定制的行动计划模板。对“营养日2.0”的评估正在进行，将包括对“营养日2.0”工具的满意度和实用性，以及对KTA差距的短期、中期和长期影响。
在临床实践中，“营养日2.
