Organisational Culture and Nutritional Care

• ClinicalTrials.gov Identifier: NCT03963778
• Recruitment Status: Completed
• First Posted: May 28, 2019
• Last Update Posted: January 5, 2022
• Sponsor: Bournemouth University
• Collaborator: Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
• Information provided by (Responsible Party): Bournemouth University

Study Description

Brief Summary:

The study explores the impact of organisational culture on multidisciplinary teams in the provision of nutritional care for older hospitalised acute in-patients by collaborating with patients and/or their relatives and healthcare practitioners to influence change.

Condition or disease	Intervention/treatment
Nutrition	Behavioral: Improving nutritional care

Detailed Description:

This study adopts an action research (AR) approach given that sustained change is more likely if it incorporates authentic staff engagement. The key choice made in formulating the research design is to adopt an approach that is collaborative and participatory in a process of action and learning.

Here, eligible health practitioners involved in any aspect of the patients' food and nutritional care or helping to feed patients during mealtimes would be represented in one central team, engaging as co-researchers in the study.

Patients and/or relatives will participate in a focus group or interview session. The AR team participants will be involved in the iterative action research cycle, reflecting on current nutritional care practices, collectively evaluate patients' stories and consider ways to improve eating and drinking on the wards. The AR team will meet throughout the course of 12 months.

The study will provide insight into the impact of organisational culture ('the way the investigators do things') in the delivery of good nutritional care and elucidate the roles and responsibilities of nurses and other staff groups involved in the provision of nutritional care.

This research will provide data on the organisational culture of interdisciplinary teams working at both micro and macro levels while providing insight into the potential for AR to be used in a wider arena within the hospital to improve practice.

Study Design

• Study Type: Observational
• Actual Enrollment: 24 participants
• Observational Model: Case-Only
• Time Perspective: Other
• Official Title: A Study Investigating the Impact of Organisational Culture on Nutritional Care in Hospitalised Patients
• Actual Study Start Date: September 17, 2018
• Actual Primary Completion Date: September 1, 2021
• Actual Study Completion Date: December 1, 2021

Groups and Cohorts

Intervention Details:

• Behavioral: Improving nutritional care
  The interventions will be co-designed with the action research team

Outcome Measures

Primary Outcome Measures :

1. Focus Group sessions / Action research team meetings [ Time Frame: 12 months ]

   The action research team will have focus group/meetings involving health professionals willing to participate as co-researchers to collectively draw on their experiences to collaborate and implement interventions to improve nutritional care delivery for patients following the iterative AR cycles; planning, taking action, observing and evaluating interventions. The group meetings will be spread across 12 months.

   Outcome measures are obtained from interventions implemented as agreed by the team and as informed by preliminary data (such as the Malnutrition Universal Screening Tool ('MUST') audit).

Secondary Outcome Measures :

1. Interview/focus group [ Time Frame: 8 months ]
   Semi-structured interview or focus group with patients and /or their relatives willing to share their experiences on food and nutritional care.
2. Malnutrition Universal Screening Tool Hospital Audit. [ Time Frame: 18 months ]
   Evaluation of 'MUST' Audit pre and post intervention.

Eligibility Criteria

• Ages Eligible for Study: 65 Years and older (Older Adult)
• Sexes Eligible for Study: All
• Sampling Method: Non-Probability Sample

Study Population

Recently discharged patients from an acute healthcare setting.

Criteria

Inclusion Criteria:

• Recently discharged patients aged 65 or over
• Recently discharged patients at the time of data collection
• Who at the time of admission received oral nutrition and hydration

Exclusion Criteria:

• Patients aged under 65
• Current in-patients
• Patients who have had no oral nutrition. e.g patients who had Percutaneous Endoscopic Gastrostomy (PEG) feeds whilst admitted
• Patients who are feeling too unwell to participate
• Patients lacking the mental capacity to give verbal or written consent

Contacts and Locations

Locations

United Kingdom

Bournemouth University

Bournemouth, Dorset, United Kingdom, BH1 3LH

Sponsors and Collaborators

Bournemouth University

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Investigators

• Study Director: Janet Scammell, PhD; Associate Professor

More Information

• Responsible Party: Bournemouth University
• ClinicalTrials.gov Identifier: NCT03963778
• Other Study ID Numbers: 1718/IRASGY/1
• First Posted: May 28, 2019
• Last Update Posted: January 5, 2022
• Last Verified: January 2022

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Bournemouth University:

Malnourishment; Nutritional Deficiency; Undernutrition