Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 30, 2024
Open Peer Review Period: May 30, 2024 - Jul 25, 2024
Date Accepted: Oct 29, 2024
(closed for review but you can still tweet)
Spread and scale of the Integrated Nutrition Pathway for Acute Care across Canada: protocol for the Advancing Malnutrition Care (AMC) program
ABSTRACT
Background:
A high proportion of patients admitted to hospital are at nutrition risk or have malnutrition. However, this risk is often not identified at admission, which may result in a longer length of stay and increased likelihood of death. The Integrated Nutrition Pathway for Acute Care (INPAC) was developed to provide clinicians with a standardized approach to prevent, detect, and treat malnutrition in hospital.
Objective:
Advancing Malnutrition Care (AMC) is a program developed to spread and scale INPAC across Canadian hospitals.
Methods:
A prospective, longitudinal, mixed-methods design is proposed to evaluate the spread and scale up of INPAC best practices across Canadian hospitals using a mentor-champion model. Purposive and snowball sampling are used to recruit mentors and hospital champions to participants in the AMC program. In the program, regional mentors and hospital champions are trained virtually on their roles and activities. Regional mentors meet with hospital champions in their area monthly to support them with making practice change. Hospital champions use AMC program-specific tools and resources to implement improvements and collect site information via quarterly audits of patient charts to track implementation of nutrition care best practices. A prospective evaluation will be conducted to assess the impact of the program and explore how it can be sustainably scaled-up across Canada. Semi-structured interviews will be used to gain a deeper understanding of mentor and champion experiences in the program.
Results:
As of June 2024, 19 mentors and 42 champions were enrolled and a total of 112 audits had been submitted. Data collection is ongoing and expected to continue until June 2025.
Conclusions:
Evaluation of the AMC program will strengthen decision making, future programming, and will inform program changes that reflect implementation of best practices in nutrition care while supporting regional mentors and hospital champions. This work will address the sustainability of AMC and the critical challenges related to hospital-based malnutrition, ultimately improving nutrition care for patients across Canada.
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