Browsing by Author "Jobber, CJD"

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The incorporation of body composition assessments as part of routine clinical care in a tertiary hospital's dietetic department: a best practice implementation project
Wilkinson, SA ; Jobber, CJD ; Nave, F ; van der Meij, BS
2022, Article / Letter to editor (JBI EVIDENCE IMPLEMENTATION, vol. 20, iss. 1, (2022), pp. 21-32)Objectives: Our aim was to incorporate body composition assessment (BCA) into dietetic department procedures using interventions tailored to previously identified barriers and enablers. Introduction: BCA is recommended as part of routine malnutrition assessment and follow-up but is not yet part of usual care. Methods: Evidence-informed strategies to overcome barriers and enablers were operationalized and delivered as three overarching interventions: upskilling (professional development strategy), modelling and reducing fear of change (Clinical Champion project), and embedding as usual practice (departmental integration). Process evaluation assessed intervention fidelity. A survey assessed utilization of BCA devices, (perceived) competency, and attitudes of clinical dietitians towards BCA before and after interventions. Results: Two of the three elements were incorporated as planned (upskilling and embedding as usual practice), with one element (modelling and reducing fear of change) modified through iterative processes. The Clinical Champion project ran for 12 rather than 6 months, and resulted in the majority of champions confident with their skills, completing BCA within their daily clinical workload and feeling BCA was useful. Pre-surveys and post-surveys within the department of 26 dietitians showed a marked reduction in most perceived barriers and improved recognition of enablers across all theoretical framework domains; with a large proportion of 'not applicable' responses given for many barriers at follow-up. Conclusion: This evidence-informed implementation strategy successfully integrated BCA into dietitians' practice and departmental processes highlighting direction for future service changes. Continual assessment of barriers and success of integration into routine workloads is required to facilitate this.
Using the theoretical domains framework to inform strategies to support dietitians undertaking body composition assessments in routine clinical care
Jobber, CJD ; Wilkinson, SA ; Hughes, EK ; Nave, F ; Meij, B.S. van der
2021, Article / Letter to editor (BMC Health Services Research, vol. 21, iss. 1, (2021))BackgroundMalnutrition, sarcopenia and cachexia are clinical wasting syndromes characterised by muscle loss. Systematic monitoring by body composition assessment (BCA) is recommended for the diagnosis, treatment and monitoring of the syndrome(s). This study investigated practices, competency, and attitudes of Australian dietitians regarding BCA, to inform a local implementation process.MethodsApplying the Action cycle in the Knowledge to Action framework, surveys were distributed to the 26 dietitians of an 800-bed tertiary hospital. The survey assessed barriers and enablers to performing routine BCA in clinical care. Results were categorised using the Theoretical Domains Framework (TDF) and suitable interventions mapped using the Behaviour Change Wheel.ResultsTwenty-two dietitians (84.6%) completed the survey. Barriers to BCA were identified in all TDF domains, particularly in Knowledge, Skills, Social/professional role and identity, Beliefs about capabilities, and Environmental context and resources. Enablers existed in domains of: Skills; Beliefs about consequences; Goals; Environmental context and resources; Social influences; Intentions; Optimism; Reinforcement.ConclusionsThis study showed that hospital dietitians experience individual, team, and organisational barriers to adopt BCAs in clinical practice. We were able to formulate targeted implementation strategies to overcome these barriers to assist BCA adoption into routine practice.

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Browsing by Author "Jobber, CJD"

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