Individual and contextual factors in the Swedish Nutrition Care Process Terminology implementation.

Elin Lövestam, Ylva Orrevall, Anne-Marie Boström
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Abstract

Background: Standardised terminologies and classification systems play an increasingly important role in the continuous work towards high quality patient care. Currently, a standardised terminology for nutrition care, the Nutrition Care Process (NCP) Terminology (NCPT), is being implemented across the world, with terms for four steps: Nutrition Assessment (NA), Nutrition Diagnosis (ND), Nutrition Intervention (NI) and Nutrition Monitoring and Evaluation (NME).

Objective: To explore associations between individual and contextual factors and implementation of a standardised NCPT among Swedish dietitians.

Method: A survey was completed by 226 dietitians, focussing on: (a) NCPT implementation level; (b) individual factors; and (c) contextual factors. Associations between these factors were explored through a two-block logistic regression analysis.

Results: Contextual factors such as intention from management to implement the NCPT (OR (odds ratio) ND 15.0, 95% Confidence Interval (CI) 3.9-57.4, NME 3.7, 95% CI 1.1-13.0) and electronic health record (EHR) headings from the NCPT (OR NI 3.6, 95% CI 1.4-10.7, NME 3.8, 95% CI 1.1-11.5) were associated with higher implementation. A positive attitude towards the NCPT (model 1 OR ND 3.8, 95% CI 1.5-9.8, model 2 OR ND 5.0, 95% CI 1.4-17.8) was also associated with higher implementation, while other individual factors showed less association.

Conclusion: Contextual factors such as intention from management, EHR structure, and pre-defined terms and headings are key to implementation of a standardised terminology for nutrition and dietetic care.

Implications for practice: Clinical leadership and technological solutions should be considered key areas in future NCPT implementation strategies.

瑞典营养护理流程术语实施过程中的个体因素和环境因素。
背景:标准化术语和分类系统在不断提高患者护理质量的过程中发挥着越来越重要的作用。目前,营养护理标准化术语--营养护理流程(NCP)术语(NCPT)正在全球范围内实施,其中包含四个步骤的术语:营养评估(NA)、营养诊断(ND)、营养干预(NI)和营养监测与评估(NME):目的:探讨瑞典营养师个人因素和环境因素与实施标准化 NCPT 之间的关联:226名营养师完成了一项调查,重点关注:(a) NCPT实施水平;(b) 个人因素;(c) 背景因素。通过两组逻辑回归分析探讨了这些因素之间的关联:结果:管理层实施 NCPT 的意向(OR(几率比)ND 15.0,95% 置信区间(CI)3.9-57.4,NME 3.7,95% CI 1.1-13.0)和 NCPT 中的电子健康记录(EHR)标题(OR NI 3.6,95% CI 1.4-10.7,NME 3.8,95% CI 1.1-11.5)等背景因素与较高的实施率相关。对 NCPT 的积极态度(模型 1 OR ND 3.8,95% CI 1.5-9.8;模型 2 OR ND 5.0,95% CI 1.4-17.8)也与较高的实施率相关,而其他个体因素的相关性较小:结论:管理层的意愿、电子病历结构、预先定义的术语和标题等环境因素是实施营养与饮食护理标准化术语的关键:对实践的启示:临床领导力和技术解决方案应被视为未来 NCPT 实施战略的关键领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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