Development, implementation and evaluation of the role of dietetic assistants in tackling malnutrition: What worked, what didn’t and why it matters?

Antonella Jarvis1,2, Saravana Kumar1, Georgina Rassias2

1School of Health Sciences, International Centre for Allied Health Evidence (iCAHE), C7-61 City East Campus, University of South Australia, Adelaide, SA 5000, kumar@unisa.edu.au
2Clinical Dietetics Department, Royal Adelaide Hospital, North Tce, Adelaide, SA 5000

Background

With an ageing population requiring ongoing health care, the frequency of hospital visits continues to rise. Within these settings, malnutrition among the elderly is a well-recognised problem, which requires dietetic intervention. While the importance of addressing malnutrition through dietetic interventions are well recognised, due to lack of timely identification, competing clinical priorities, staffing issues, it is often not addressed. This is especially the case in rural and remote areas where access to care may be limited due to staffing and resource limitations. Dietetic assistants (DAs) could assist in tackling malnutrition and this project tested this new model of care.

Methods

A systematic scoping literature search was undertaken to identify the evidence for the role of DAs. A comprehensive change management strategy was adopted. A targeted training package was developed for and delivered to DAs within a large tertiary hospital by a senior dietitian. Qualitative and quantitative data were collected to demonstrate the impact of DAs across a range of measures.

Results

The literature evidence (n=5) highlighted the positive impact on acute patient nutritional intake, anthropometric indices and ability to assist in reducing mortality. Qualitative interviews with DAs (n=3) and dietitians (n=4) revealed support for this role in practice. Quantitative data indicated improved access to dietetic care and timely intervention with patients (n=25) satisfied with the DA interactions.

Discussion

Despite these positive findings, implementing a new model of care was fraught with challenges. While health reform and innovation continues to be at forefront, effectively translating these into practice continues to face barriers.

Biography

Antonella Jarvis is a clinical dietitian having worked for OPAL in the past and is now the Plastics,Vascular and Cardio dietitian at the Royal Adelaide Hospital (RAH). In addition to clinical dietetics, she is also conducting a patient trial of Arginine supplementation in relation to wound healing and undertaking a review, and updating, of wound healing guidelines. Antonella also works part-time at the University of South Australia as a research assistant and has assisted on several projects including the Transforming Health 7 day Allied Health, impact of allied health snapshots and the role of students during times of change