Multifaceted intervention to enhance the screening and care of hospitalised malnourished children: study protocol for the PREDIRE cluster randomized controlled trial

Autor: Sandrine Touzet, Guillaume Gamba, Noël Peretti, Fleur Cour-Andlauer, Antoine Duclos, Angélique Denis, Daniel Betito, Lioara Restier-Miron, Pauline Occelli, Stéphanie Polazzi, Cyrille Colin, Alain Lachaux
Přispěvatelé: BMC, Ed., Pôle Information Médicale Evaluation Recherche (IMER), Hospices Civils de Lyon (HCL), Santé Individu Société - SIS (SIS), Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition Pédiatrique, Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Direction du Système d'Information et de l'Informatique, Hospices Civils de Lyon - Groupement Hospitalier Est, CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), This study was supported by a grant from the Programme de Recherche en Qualité Hospitalière 2008 of the French Ministry of Health (Ministère chargé de la Santé, Direction de l'Hospitalisation et de l'Organisation des Soins)., The PREDIRE Study Group, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université Lumière - Lyon 2 (UL2), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Santé Individu Société (SIS), Université de Lyon-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
medicine.medical_specialty
Multifaceted intervention
Adolescent
Cluster randomized trial
030204 cardiovascular system & hematology
Child Nutrition Disorders
Health administration
law.invention
03 medical and health sciences
Study Protocol
0302 clinical medicine
Randomized controlled trial
law
Health care
Medical Staff
Hospital
Medicine
Cluster Analysis
Humans
Mass Screening
Nutritional support team
030212 general & internal medicine
Cluster randomised controlled trial
Intensive care medicine
Child
Mass screening
Patient Care Team
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
Computerized clinical decision support system
business.industry
Nursing research
Health Policy
Infant
medicine.disease
Decision Support Systems
Clinical
3. Good health
Hospitalization
Malnutrition
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Child
Preschool
Observational study
Female
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
France
business
Malnourished children
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: BMC Health Services Research
BMC Health Services Research, BioMed Central, 2013, 13 (1), pp.107. ⟨10.1186/1472-6963-13-107⟩
BMC Health Services Research, 2013, 13 (1), pp.107. ⟨10.1186/1472-6963-13-107⟩
ISSN: 1472-6963
DOI: 10.1186/1472-6963-13-107⟩
Popis: International audience; BACKGROUND: Hospital malnutrition is an underestimated problem and as many as half of malnourished patients do not receive appropriate treatment. In order to extend the management of malnutrition in health care facilities, multidisciplinary teams focusing on clinical nutrition were established in France. The establishment of such teams within hospital facilities remains nonetheless difficult. We have consequently developed a multifaceted intervention coordinated by a Nutritional Support Team (NST). Our study aims to evaluate the impact of this multifaceted intervention coordinated by a NST, in adherence to recommended practices for the care of malnourished children, among health care workers of a paediatric university hospital. METHODS/DESIGN: We carried out 1) a six-month observational phase focusing on the medical care procedures relative to malnourished children followed by 2) a cluster randomised controlled trial phase to evaluate the impact of a multidisciplinary nutrition team over an 18 month time frame.Based on power analyses and assuming a conservative intracluster correlation coefficient, 1289 children were needed to detect a 25% difference in rates between the two groups of the cluster trial.The implementation of our intervention was coordinated by the NST and had three major components: a) access to a computerised malnutrition screening system associated with an automatic alert system, b) an awareness campaign directed toward the health care workers and c) a leadership based strategy.Main outcomes included the number of daily weighings during hospitalisation, the investigation of malnutrition etiology and the management of malnutrition by a dietician and/or the NST.Due to the clustered nature of the data with children nested in departments, a generalized estimated equations approach will be used to analyse the impact of the multifaceted intervention on primary and secondary outcomes. DISCUSSION: Our results will provide an overall response regarding the effectiveness of our multifaceted intervention and we should be able to suggest an organization and mode of operation of NST. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01081587.
Databáze: OpenAIRE
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