My Translation Rules (MTR)

Nutrition & Dietetics Research Translation Award & Allied Health Showcase

The annual My Translation Rules (MTR) Nutrition & Dietetics Research Translation Award and inaugural Allied Health Showcase for 2018, is a celebration of research translation in clinical practice. This event encourages clinicians to critique existing research and translate findings into a clinical application within an Australian healthcare sector.

Each speaker will present a 3 to 5 minute presentation summarising a research project, undertaken within clinical practice, that could have a significant impact on hospital procedures, patient care and health outcomes. The presentations are then judged by a panel of three experts.

2018

In 2018 the MTR award was open to all dietitians in Queensland Health and Mater Group facilities. It also showcased allied health exemplar projects with the view to expand the MTR award to all allied health clinicians in Queensland Health and Mater Group facilities from 2019. 

The 2018 MTR event attracted 10 presenters, 3 showcase presentations, over 100 attendees and 10 videoconference sites around the state.

Prize category Winners Title
Overall Winner Kai Elmas - TPCH “The feasibility assessment and implementation of an easy chew diet in a tertiary facility”
Runner Up Samantha Robertson, SCUH “Implementation of nutrition screening and optimising nutrition management in acute stroke”
New Presenter Award Hilary Powlesland, RBWH “Effectiveness of Group Education to reduce sodium intake in patients with Chronic Kidney Disease”
Lessons Learnt Award Danielle Brewer, TBH “Review of enteral feeding practices in an acute stroke unit”
Partnerships Award Nicci Muggeridge, TPCH “Engaging patients and staff to determine facilitators and barriers to dining room attendance in a rehabilitation ward”
People's Choice Award Tayla Robertson, PAH “Early oral feeding after colorectal surgery: a mixed methods study of knowledge translation”
Enabling Implementation Award Marnie Seabrook, Director of Speech Pathology,
Logan Hospital
 

2018 Presenters

Kai Elmas - The feasibility assessment and implementation of an ‘Easy chew’ diet in a tertiary hospital facility

Patients with chewing difficulties in the absence of dysphagia at TPCH have previously been placed on a Soft diet. The Soft diet is clinically prescribed for patients with dysphagia and is highly restrictive to align with therapeutic diet guidelines. The Easy Chew diet was developed, implemented and evaluated utilising all aspects of the knowledge to action framework in collaboration with the senior foodservice Speech Pathology team. This project led to an increase in patient choice by up to 300%, significant increase in correct prescription of soft and easy chew diets, and decreased unnecessary use of soft diet codes across the hospital.

Samantha Robertson - Implementation of malnutrition screening and optimising nutrition management in acute stroke

Malnourished acute stroke patients have an increased risk of mortality.

Problem addressed: This project investigated the effectiveness of Allied Health Assistants (AHAs) in completing malnutrition screening on the acute stroke ward.

Implementation strategy: The Knowledge to Action (KTA) Framework was utilised as an implementation strategy where barriers and enablers were assessed.

Outcomes: Main outcomes of the project included improved time management and cost savings, thereby ensuring high value dietetic health care provision on the acute stroke ward. This has been a sustainable change with AHA malnutrition screening still effectively being conducted on the ward with ongoing evaluation.

Hilary Powlesland - Effectiveness of group education to reduce sodium intake in patients with chronic kidney disease

Problem addressed: RBWH chronic kidney disease outpatient clinics experienced a 300% increase in service demand; and a 7-month wait time for a dietitian appointment developed. 81% of all patients were referred for individual low sodium dietary education.

Implementation strategy: To increase efficiency and reduce wait time, a pilot study was run to assess feasibility and effectiveness of patient group education. Using the i-PARIHS framework key implementation barriers and enablers were identified.

Outcomes: A clinically & statistically significant reduction in dietary sodium intake was achieved in 78% of group participants. Resultantly, appointment wait time reduced by 3-months, and the group education model of care has been permanent adopted in the service.

Danielle Brewer - Review of enteral feeding practices in an acute stroke unit – How it should have happened

Problem Addressed: Enteral feeding practices in our acute stroke and sub-acute ward differed from standard practice; there were concerns regarding inadequate enteral nutrition provision and extended periods to reach goal regimens.

Implementation Strategy: The Knowledge to action cycle was used for project implementation. In hindsight, Consolidated Framework for Implementation Research (CFIR) or Promoting Action on Research Implementation in Health Services (i-PARIHS) may have achieved better results.

Outcomes: It was expected the project would deliver improved outcomes for patients, reduce hospital costs, and result in standardised procedures and protocols. The scope of this project in now being broadened into a facility-wide early enteral feeding process.

Nicci Muggeridge - RAS mealtime experiences project

Tayla Robertson - Early Oral Feeding After Colorectal Surgery: A mixed methods study of knowledge translation

Problem Addressed: Practice guidelines recommend early oral feeding (EOF) as an unrestricted diet within 24 hours of surgery.

Implementation Strategy: Evaluation of EOF after elective colorectal surgery was facilitated by the Knowledge to Action Implementation Framework, including a quantitative observational longitudinal audit of postoperative feeding, qualitative staff interviews of perceptions with EOF, and subsequent stakeholder consultation.

Outcomes: Over the project timeline median time to commencement of full (unrestricted) diet improved from postoperative day four (Jun-July 2016) to postoperative day zero (Jan-Feb 2018), consistent with practice guidelines. Patients prescribed a full diet on operation report increased from 0% to 82% over the same period. 

Lindsey Webb - Implementation of a standardised Mixed Meal Test protocol to diagnose reactive hypoglycaemia

Problem addressed: The ‘meal’ component of the mixed meal test used to diagnose reactive hypoglycaemia at the Princess Alexandra Hospital was being administered with little standardisation.

Implementation strategy: The PARiHS framework was applied.  Evidence was reviewed by critically appraising the literature, benchmarking with other hospitals and auditing past test results. The project was supported by key stake holders including Endocrinologists, Endocrine nurses and the Food Service Department.

Outcomes: A new mixed meal test protocol was written including an updated meal composition.  Benefits include: improved accuracy of reactive hypoglycaemia diagnosis; reduction of food safety risks; 80% cost saving, and possibility of protocol to be used Australia wide.

Liz Purcell - Exclusive enteral nutrition (EEN) adherence in adult patients with small bowel Crohn’s Disease (SBCDx)

Problem addressed: EEN use in adult patients with small bowel Crohn’s disease has been limited by perceived compliance issues, inexperience with EEN amongst clinicians and a lack of support.  Our aim is to create a new model of care which improves adherence to EEN which can decrease the need for high risk steroids, improve mucosal healing, nutritional status and quality of life.

Implementation strategy: iPARiHS

Outcomes: 85% successfully completed and adhered to the regimen and 69% achieved clinical improvement. These outcomes have the potential to provide additional treatment options and improve care for patients with CD at Logan Hospital.

Lynette De Groot - Iterative improvement in a malnutrition screening process in a cancer care day unit

Problem addressed: Malnutrition is common in cancer patients, however consistent malnutrition screening is challenging in a day oncology unit. At the Mater Cancer Care Centre, malnutrition screening practices were ad hoc, resulting in suboptimal treatment of malnutrition.

Implementation strategy: The implementation of a routine nutrition screening process was guided by the knowledge-to-action framework steps. This included; reviewing literature, auditing, stakeholder engagement, local context investigations, and the implementation, evaluation and monitoring of a routine malnutrition screening tool.

Outcomes: Initial evaluation following implementation resulted in a 200% increase in patient contact. Routine screening and subsequent dietetic intervention will help improve and maintain the nutritional status of patients undergoing cancer treatment.

Nikki Smith - Implementation of a liberalised Refeeding Syndrome Guideline based on up-to-date research

Problem addressed:  Most Refeeding Syndrome (RFS) guidelines initiate intake at a low rate (~4MJ/day). Latest research indicates a higher caloric protocol (6MJ/day) appears to be safe.

Implementation:

  1. Literature review conducted
  2. Data collected 3 months pre- and post-implementation
  3. Engaged respected leaders
  4. Conducted in-service
  5. Stakeholders voted
  6. Guideline updated: “Commence feeding at 6,000kJ/day or 100% of requirements, whichever is less”.

Outcomes:

  • Fewer patients were documented at risk of RFS post guideline implementation (pre-guideline: 15% (n=25/162); post-guideline: 8% (n=11/137). 
  • Findings not significantly different given the small sample.
  • Dietitians less likely to restrict intake (No restriction: pre:61% vs. post:91%, p=0.387). 
  • Low electrolyte incidence equally likely (pre:84% vs. post:73%, p=0.650)

Past Events

2017

The 2017 MTR event attracted 10 presenters, over 80 attendees and 18 videoconference sites around the state.

Event Video

Event Photos

Winners

Prize category Sponsored by Project Eligibility Winners
Overall Winner AusHSI - Annual Registration to all 2018 AusHSI workshops (value of >$2000) All eligible – Overall best project decided by judging panel Joanne Roddick
Runner Up DNSC - 2018 DAA Conference registration All eligible Clare Kreis
Most Collaborative DNSC - Myer Voucher Project must demonstrate multi-disciplinary collaboration Ayala Rogany
Partnerships PAH Nutrition & Dietetics - Cookbook Project must demonstrate multi-site participation or partnerships with other health services, institutes or industry Clare Kreis
Education Dietitian Connection - One year subscription to DC webinar library Project must demonstrate an education component Hannah Mackay
Best New Presenter Dietitian Connection - Registration to DC 2018 Dietitians Unite Event This award is restricted to those principal entrants who have not previously presented at any research translation forum. Carrie-Anne Lewis
People’s Choice PAH Nutrition & Dietetics - Cookbook All eligible – selected by the audience Tayla Robertson
 

Judging panel

Dr Kate Kynoch, Director Evidence in Practice Unit and the QLD Centre for Evidence Based Nursing and Midwifery at Mater Health in Brisbane

Dr Kynoch has over 15 years clinical nursing and research experiences and he role involves promoting the use of evidence in practice, including overseeing clinical policy development for the organisation, and assisting clinical staff with translating research evidence into clinical care.

Dr Sonya Osborne, Senior Research Fellow AusHSI, QUT

Dr Osborne has a clinical background in nursing and a high level of expertise in quality patient care, evidence-based practice, and the emerging fields of implementation and improvement science. During her 15-year career as a health researcher, Dr Osborne has worked for a number of well-respected hospitals and universities within Australia as an educator, project director and academic.

Dr Sally Eames, Clinical Evidence Development Officer in Community Indigenous and Subacute Services (CISS), Metro North HHS

Dr Eames role supports and builds capacity of clinicians to use evidence based practice (EBP) and knowledge translation (KT). After completing her PhD in stroke education, she held roles as: Senior/Advanced Occupational Therapy (OT) in various Geriatric and Rehabilitation services; EBP Coordinator for the PAH’s OT Department; Research Fellow in the Centre for Research in Evidence Based Practice (CREBP) at Bond University; and Project Lead (knowledge translation) in CISS.

2016

Interviews and Podcasts - Clare Dux - Most Collaborative Award

Ingrid talks with Clare Dux from the RBWH about her multidisciplinary project to successfully implement enteral feeding protocols. 

Listen to Clare's interview

2015

Interviews and Podcasts - Melissa Gilroy & Denise Page – MTR Award

Ingrid talks with Melissa Gilroy and Denise Page form the Mater Hospital about their joint work on the ‘Research into Practice Early Nutrition (RIPEN) Project’ that has made a real impact on infant nutrition.

Listen to Melissa and Danise's interview

2014

Interviews and Podcasts - Amy Nevin – People’s Choice Award

Ingrid talks with Amy Nevin from the PA Hospital about her role in implementing the use of technology for best dietetic practice in spinal cord injury rehabilitation and how it has taken her around the world to share her findings.

Listen to Amy's interview

Please do not hesitate to contact the AH-TRIP team: [email protected]