Barriers and enablers in the implementation of a standardised process for nutrition care: findings from a multinational survey of dietetic professionals in 10 countries

E Lövestam; A Vivanti; A Steiber; A-M Boström; A Devine; O Haughey; C M Kiss; N R Lang; J Lieffers; L Lloyd; T A O'Sullivan; C Papoutsakis; C Peersen; L Thoresen; Y Orrevall; INIS Consortium members (collaborators)

doi:10.1111/jhn.12700

Barriers and enablers in the implementation of a standardised process for nutrition care: findings from a multinational survey of dietetic professionals in 10 countries

J Hum Nutr Diet. 2020 Jan 7. doi: 10.1111/jhn.12700. Online ahead of print.

Authors

E Lövestam¹, A Vivanti^{2

3}, A Steiber⁴, A-M Boström^{5

6

7

8}, A Devine⁹, O Haughey^{10

11}, C M Kiss¹², N R Lang¹³, J Lieffers¹⁴, L Lloyd¹⁵, T A O'Sullivan⁹, C Papoutsakis⁴, C Peersen¹⁶, L Thoresen^{17

18}, Y Orrevall^{19

20}; INIS Consortium members (collaborators)

Collaborators

INIS Consortium members (collaborators):
Clare Corish, Corinne Eisenbraun, Rhona Hanning, Ida Kristiansen, Sissi Stove Lorentzen, Arwen K MacLean

Affiliations

¹ Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
² Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia.
³ School of Human Movement and Nutrition Studies, University of Queensland, QLD, Australia.
⁴ Academy of Nutrition and Dietetics, Chicago, IL, USA.
⁵ Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institute, Huddinge, Sweden.
⁶ Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
⁷ Research& Development unit, Stockholms Sjukhem, Stockholm, Sweden.
⁸ Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway.
⁹ School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
¹⁰ Irish Nutrition and Dietetic Institute, Dun Laoghaire, Co., Dublin, Ireland.
¹¹ Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
¹² Clinical Nutrition, Research and Development, University Department of Geriatric Medicine FELIX PLATTER, Basel, Swiftzerland.
¹³ Department of Nutrition and Health, VIA University College, Aarhus N, Denmark.
¹⁴ College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada.
¹⁵ Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand.
¹⁶ The municipality of Trondheim, Trondheim, Norway.
¹⁷ Cancer Clinic, Trondheim University Hospital, Trondheim, Norway.
¹⁸ National Advisory Unit on Disease-Related Malnutrition, Oslo University Hospital, Oslo, Norway.
¹⁹ Function Area Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden.
²⁰ Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

PMID: 31912581
DOI: 10.1111/jhn.12700

Abstract

Background: To explore the barriers and enablers experienced by nutrition and dietetic professionals in the implementation of the standardised Nutrition Care Process (NCP) across 10 different countries. NCP related beliefs, motivations and values were investigated and compared.

Methods: A validated online survey was disseminated to nutrition and dietetics professionals in 10 countries in the local language during 2017. Cross-sectional associations and differences between countries were explored for level of implementation, barriers/enablers and attitudes/motivation among the respondents.

Results: Higher NCP implementation was associated with greater occurrence of enabling aspects, as well as fewer occurrences of barriers. The most common enabler was 'recommendation by the national dietetic association' (69%) and the most common barrier was 'lack of time' (39%). A longer experience of NCP use was associated with a more positive attitude towards all NCP aspects. Differences between countries were identified, regarding both the occurrence of barriers/enablers and attitudes/motivations.

Conclusions: Implementation efforts need to be tailored to country-specific contexts when implementing a new standard of care framework among nutrition and dietetic professionals. Additional research is needed to further assess the management and workplace strategies to support the development of nutrition and dietetics professionals in multidisciplinary healthcare organisations.

Keywords: dietetic practice; healthcare organisation; healthcare process; implementation; nutrition care process; nutrition care process terminology.

Abstract

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