Nutrition Disorders
Conditions
Keywords
Non MeSH terms:, Children, Malnutrition, Computer Clinical Decision Support System, Cluster randomized trial, Healthcare workers, Guideline adherence, Patient safety, MeSH terms:, Nutrition Surveys, Secondary Prevention, Pediatrics, Child Care, Health Personnel, Reminder Systems, Intervention Studies, Quality of Health Care
Brief summary
This cluster-randomized trial will evaluate the impact of a multifaceted intervention (including electronic medical alerts) coordinated by a Nutritional Support Team, on adherence to recommended practices for care of starved children, among health personnel of a large university hospital. A key component of the study is to assess whether improved adherence to guidelines leads to a reduction in rates of complications.
Interventions
PROCEDUREAccess to a Computerized Clinical Decision Support System (CCDDS)
Automatic CCDSS will alert physician for each case of malnourished using an algorithm based on age, sex, weight and size of each hospitalized children.
BEHAVIORALEducation of Healthcare workers
Education of the hospital staff to evidence-based practices in malnutrition care will be proposed in the experimental arm. Specific training will be targeted on participants according to their function.
OTHERLocal assistance by a dietician
Assistance will be conducted locally by a local dietician. Periodic multidisciplinary meetings will be attended by the hospital staff belonging to the intervention arm, including the analysis of clinical incidents related to nutrition care.
Sponsors
Hospices Civils de Lyon
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
* medical and surgical units in a large teaching hospital providing pediatric acute care. * any hospital staff with direct patient care who are affiliated with a single unit (includes physicians, nurses, nursing assistants, physiotherapists, dieticians. * all children recorded as malnourished at their entrance in hospital
Exclusion criteria
* neonatal and intensive care units. * any hospital staff with direct patient care who are not affiliated with a single unit. * age under one month, liver or kidney abnormalities, severe heart failure, stay less than 2 days.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Adherence to recommended practices (including weigh in, physiotherapy, nutrition survey and monitoring) | At least 2 days depending on the hospitalisation time |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of complications | At least 2 days depending on the hospitalisation time |
| Nutritional status evolution | At least 2 days depending on the hospitalisation time |
| Mean length and cost of stay | At least 2 days depending on the hospitalisation time |
| Appropriate call-in Nutritional Support Team | At least 2 days depending on the hospitalisation time |
Countries
France
Outcome results
None listed