‘Innovative Nutrition & Swallowing Training’ Leah Platt Community Dietitian September 2011.
-
Upload
reynold-anderson -
Category
Documents
-
view
219 -
download
0
Transcript of ‘Innovative Nutrition & Swallowing Training’ Leah Platt Community Dietitian September 2011.
Portsmouth Hospitals NHS Trust
Background to Project
Funded by NESC.
7 Month project to deliver bespoke training programmes to Nursing Homes in Portsmouth City.
Joint Project between SALT (Solent Healthcare) and Dietitian (Portsmouth Hospitals NHS Trust).
Portsmouth Hospitals NHS Trust
Project AimReduce hospital admissions from nursing homes by
enhancing local skills in identifying and managing risks of
malnutrition and dysphagia.
Objectives Implement accurate ‘MUST’ screening and appropriate
use of care plans
Improve the identification of dysphagia and use of safer
swallowing strategies
Improve mealtime experiences
Portsmouth Hospitals NHS Trust
Project OverviewIdentified / invited homes Engaged stakeholders
Visited homes
Piloted Training
Reflected & revised
Assessed training needs
Pre-training data
Delivered training
Developed tailored training
Portsmouth Hospitals NHS Trust
Delivered follow-up training
Collected post-training data(4-6 weeks post training)
Analysed and evaluated training
Practical recommendations discussed
Produce Recommendations and Publicise Findings
Portsmouth Hospitals NHS Trust
Why was this training
different?
EvaluatedEffectiveness
DualProfessional
Provided tailored
programmes
Engaged NHIn assessment
of training needs
Groupand
IndividualTraining
Used varietyof teaching
methods
Portsmouth Hospitals NHS Trust
Reaction of Students
Learning
Behaviour
Results
Did targeted outcomes improve?
Did the training increase
knowledge?
How did participants react
to training?
Did behaviour change?
Outcome Measurement: Kirkpatrick’s Training Model
Portsmouth Hospitals NHS Trust
Outcome: Reaction of Students
Reaction of Students
Learning
Behaviour
Results
How did participants
react to training?
Portsmouth Hospitals NHS Trust
Reaction from Participants
Good reaction from participants
1 2 3 4 5 4.8
- Clarity, Interest, Relevance
Portsmouth Hospitals NHS Trust
Increased ConfidenceCompleting 'MUST'
0
1
2
3
4
5
6
7
8
9
10
Pre-Training Post-Training
- High confidence ratings for supporting residents at mealtimes both pre & post training
Portsmouth Hospitals NHS Trust
Outcome: Learning
Reaction of Students
Learning
Behaviour
Results
Did the training increase
knowledge, skills, attitudes,
confidence, commitment?
Portsmouth Hospitals NHS Trust
Improved Knowledge
0
10
20
30
40
50
60
70
80
90
Nutrition Dysphagia Overall
Topics
Ave
rag
e S
core
(%
)
Pre-Training Post-Training
Portsmouth Hospitals NHS Trust
Outcome: Behaviour
Reaction of Students
Learning
Behaviour
Results
Did behaviour change?
Did people apply knowledge on
the job?
Portsmouth Hospitals NHS Trust
Continued Completion of ‘MUST’
- Improved frequency of ‘MUST’completition post training
- More staff involved with ‘MUST’ and care planning
Portsmouth Hospitals NHS Trust
Increased Provision of Snacks
Increased Provision of Homemade Fortified Milkshakes
Portsmouth Hospitals NHS Trust
Increased Use of Food Fortification Ingredients
- Dried milk powder, condensed milk, evaporated milk, cream, cheese, butter/margarine
0
2
4
6
8
10
12
14
16
Pre Post
Ave
rage
No.
Litr
es C
ream
Ord
ered
Wee
kly
Portsmouth Hospitals NHS Trust
0
2
4
6
8
10
12
14
16
Condensed Milk Evapourated Milk
Av
era
ge
No
. Tin
s O
rde
red
We
ek
ly
Pre Post
Increased Use of Fortification Ingredients
Portsmouth Hospitals NHS Trust
Improved Mealtime PracticesImproved Positioning
0
0.5
1
1.5
2
Positioning of Resident Positioning of Staff whenAssisting
Ave
rag
e S
core
s A
cro
ss A
ll N
urs
ing
Ho
mes
Pre Training Post TrainingImproved Feeding Practices
0
0.5
1
1.5
2
Spoon Placement Bolus Size Rate of Feeding
Ave
rag
e S
core
Acr
oss
All
Nu
rsin
g H
om
es
Portsmouth Hospitals NHS Trust
Outcome: Results
Reaction of Students
Learning
Behaviour
Results
Did targeted outcomes improve?
Portsmouth Hospitals NHS Trust
In year prior to training:
924 GP Contacts 383 admissions to Hospital
Plan to Re-Assess Next Year
Portsmouth Hospitals NHS Trust
Future Actions…
Collect GP Contacts & Hospitals Admissions Data 1Year Post Training
Nutrition & Dysphagia Link Training
1 Day Diet Chef Course
Portsmouth Hospitals NHS Trust
Learning Points
• Recognition that changes in practice requires intensive input. ? Impact on Resources
• Importance of regular training
•Importance of Evaluation Methods