ALLIED HEALTH TRANSLATING RESEARCH INTO PRACTICE (AH-TRIP) SHOWCASE

The annual AH-TRIP Showcase for 2019, is a celebration of research translation in clinical practice. This free, half-day event encourages clinicians to critique existing research and translate findings into a clinical application within an Australian healthcare sector. There will be 12 statewide allied health presentations. Each speaker will present a 5 to 7 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 experts.

The four award categories all allied health clinicians will be competing for are

• The 'My Translating Rules' Award
• Partnerships Award
• New Presenter Award
• Lessons Learnt Award

There will also be an AH-TRIP Enabling Implementation Award that aims to recognise those managers, team leaders or senior staff who are not researchers but who understand TRIP and are passionate about encouraging others to ‘take AH-TRIP’.

To register for this event, please click here.

Note - videoconference options will also be available.

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

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