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Process evaluation of implementing Protected Mealtimes under clinical trial conditions
Judi Porter1,2, Ella Ottrey1,3
1Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, Vic., Australia.
Journal of Advanced Nursing
|April 28, 2018
Summary
Protected Mealtimes implementation faced challenges due to staffing and trial conditions. Alternative strategies are needed to combat hospital malnutrition effectively.
Area of Science:
- Healthcare systems research
- Clinical trial process evaluation
- Nutrition support in hospitals
Background:
- Hospital malnutrition is a significant issue.
- Protected Mealtimes is a systems approach to address malnutrition.
- Previous research lacked high-quality trials on its effectiveness.
Purpose of the Study:
- To evaluate the implementation of Protected Mealtimes.
- To contrast findings with implementation fidelity.
- To understand discrepancies in clinical trial outcomes.
Main Methods:
- A prospective, stepped-wedge cluster randomized controlled trial.
- Qualitative (focus groups) and quantitative (audits, observations) data collection.
- Concept-driven coding using the Theoretical Domains Framework.
Main Results:
- Staff training was positive, but attendance was incomplete.
- Staff enthusiasm was high, with successful implementation of some aspects.
- Limited staffing and trial observer presence negatively impacted implementation and morale.
Conclusions:
- Process data revealed implementation challenges in a clinical trial setting.
- Full protocol adherence was not achieved due to environmental complexity.
- Alternative approaches are necessary to tackle hospital malnutrition.
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