Abstract
Background: Malnutrition, sarcopenia and cachexia are clinical wasting syndromes characterised by muscle loss. Systematic monitoring by body composition assessment is recommended for diagnosis, treatment and monitoring of the syndromes. However, limited literature exists regarding integration of this process into routine practice.
Aim: To incorporate body composition assessment into a dietetic department using an implementation science approach.
Methods: Using a pre-post design, we assessed use of body composition assessment devices and (perceived) competency and attitudes of clinical dietitians towards body composition assessment before and after interventions. Barriers and enablers were categorised and interventions planned. Strategies included: (1) upskilling (professional development strategy), (2) modelling and reducing fear of change (Clinical Champion project), and (3) embedding as usual practice (departmental integration).
Results: Response rates were 84.6% (22/26) and 61.9% (13/21), respectively. Barriers were identified in all framework domains. Numerous enablers also existed. Two strategies were incorporated as planned (upskilling; embedding as usual practice), with one (modelling and reducing fear of change) iteratively applied. The Clinical Champion project ran for 12 rather than 6 months. One third of champions felt supported to conduct BCA (pre), which increased to 100% (post). Pre and post surveys showed a marked reduction in most perceived barriers and improved recognition of enablers across all framework domains; with a large proportion of ‘not applicable’ given for many barriers (post).
Conclusion: Dietitians experience numerous individual, team, and organisational barriers to adopting these assessments in clinical practice. Systematic, evidence-informed implementation can facilitate integration of BCA into dietitians' practice and departmental processes.
Aim: To incorporate body composition assessment into a dietetic department using an implementation science approach.
Methods: Using a pre-post design, we assessed use of body composition assessment devices and (perceived) competency and attitudes of clinical dietitians towards body composition assessment before and after interventions. Barriers and enablers were categorised and interventions planned. Strategies included: (1) upskilling (professional development strategy), (2) modelling and reducing fear of change (Clinical Champion project), and (3) embedding as usual practice (departmental integration).
Results: Response rates were 84.6% (22/26) and 61.9% (13/21), respectively. Barriers were identified in all framework domains. Numerous enablers also existed. Two strategies were incorporated as planned (upskilling; embedding as usual practice), with one (modelling and reducing fear of change) iteratively applied. The Clinical Champion project ran for 12 rather than 6 months. One third of champions felt supported to conduct BCA (pre), which increased to 100% (post). Pre and post surveys showed a marked reduction in most perceived barriers and improved recognition of enablers across all framework domains; with a large proportion of ‘not applicable’ given for many barriers (post).
Conclusion: Dietitians experience numerous individual, team, and organisational barriers to adopting these assessments in clinical practice. Systematic, evidence-informed implementation can facilitate integration of BCA into dietitians' practice and departmental processes.
| Original language | English |
|---|---|
| Article number | 12 |
| Pages (from-to) | 55 |
| Journal | Nutrition and Dietetics |
| Volume | 78 |
| Issue number | S1 |
| DOIs | |
| Publication status | Published - Jul 2021 |
| Event | Dietitians Australia 2021 Conference: What's possible? - Melbourne Convention and Exhibition Centre, Melbourne, Australia Duration: 11 Jul 2021 → 13 Jul 2021 https://da2021.com.au |
