Have Renal Dietitians Successfully Implemented Evidence-Based Guidelines Into Practice? A Survey of Dietitians Across Australia and New Zealand

Emma J. Hall-McMahon, Katrina L. Campbell

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Abstract

Objective: Successful implementation of evidence-based practice (EBP) guidelines has been shown to improve the nutrition status of dialysis patients. This study aimed to establish use of EBP guidelines and implementation of key recommendations for nutrition assessment of dialysis patients, as well as to identify barriers and enablers associated with EBP guideline adherence. Design: A survey of nutrition assessment practices and barriers to implementation of EBP guidelines was developed and piloted. The survey measured implementation of guidelines regarding frequency of nutrition assessment and use of the subjective global assessment (SGA) to diagnose malnutrition. Barriers to guideline implementation were measured using agreement with statements rated on a Likert scale. Data were summarized as counts and percentages and analyzed using chi-squared tests of association, with P < .05 indicating statistical significance. Setting: The survey targeted specialist renal dietitians across Australian and New Zealand. Participants: Sixty-five renal dietitians from Australia and New Zealand responded to the survey. Most were females (89%, n = 58 of 65), aged <35 years (72%, n = 47 of 65), with one-third (n = 22 of 65) working in renal dietetics for longer than 4 years. Results: Nearly all participants (n = 62 of 65) reported routinely using EBP guidelines; however, only 55% and 66% indicated they had successfully implemented the guidelines regarding minimum 6-monthly nutrition assessment of dialysis patients (n = 36 of 65) and use of the SGA (n = 43 of 65), respectively. Barriers related to time, skills/self-efficacy, and an inefficient referral system were related to lower rates of guideline implementation. Conclusion: These findings indicate an evidence-practice gap in the nutritional management of dialysis patients. A standardized approach to EBP guideline implementation including structured 6-monthly nutrition assessment of dialysis patients and group training for use of the SGA tool may assist in closing this evidence-practice gap.

Original languageEnglish
Pages (from-to)584-591
Number of pages8
JournalJournal of Renal Nutrition
Volume22
Issue number6
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

Fingerprint

Nutritionists
Evidence-Based Practice
Nutrition Assessment
New Zealand
Practice Guidelines
Dialysis
Kidney
Guidelines
Guideline Adherence
Dietetics
Self Efficacy
Nutritional Status
Malnutrition
Surveys and Questionnaires
Referral and Consultation

Cite this

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title = "Have Renal Dietitians Successfully Implemented Evidence-Based Guidelines Into Practice? A Survey of Dietitians Across Australia and New Zealand",
abstract = "Objective: Successful implementation of evidence-based practice (EBP) guidelines has been shown to improve the nutrition status of dialysis patients. This study aimed to establish use of EBP guidelines and implementation of key recommendations for nutrition assessment of dialysis patients, as well as to identify barriers and enablers associated with EBP guideline adherence. Design: A survey of nutrition assessment practices and barriers to implementation of EBP guidelines was developed and piloted. The survey measured implementation of guidelines regarding frequency of nutrition assessment and use of the subjective global assessment (SGA) to diagnose malnutrition. Barriers to guideline implementation were measured using agreement with statements rated on a Likert scale. Data were summarized as counts and percentages and analyzed using chi-squared tests of association, with P < .05 indicating statistical significance. Setting: The survey targeted specialist renal dietitians across Australian and New Zealand. Participants: Sixty-five renal dietitians from Australia and New Zealand responded to the survey. Most were females (89{\%}, n = 58 of 65), aged <35 years (72{\%}, n = 47 of 65), with one-third (n = 22 of 65) working in renal dietetics for longer than 4 years. Results: Nearly all participants (n = 62 of 65) reported routinely using EBP guidelines; however, only 55{\%} and 66{\%} indicated they had successfully implemented the guidelines regarding minimum 6-monthly nutrition assessment of dialysis patients (n = 36 of 65) and use of the SGA (n = 43 of 65), respectively. Barriers related to time, skills/self-efficacy, and an inefficient referral system were related to lower rates of guideline implementation. Conclusion: These findings indicate an evidence-practice gap in the nutritional management of dialysis patients. A standardized approach to EBP guideline implementation including structured 6-monthly nutrition assessment of dialysis patients and group training for use of the SGA tool may assist in closing this evidence-practice gap.",
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Have Renal Dietitians Successfully Implemented Evidence-Based Guidelines Into Practice? A Survey of Dietitians Across Australia and New Zealand. / Hall-McMahon, Emma J.; Campbell, Katrina L.

In: Journal of Renal Nutrition, Vol. 22, No. 6, 11.2012, p. 584-591.

Research output: Contribution to journalArticleResearchpeer-review

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