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首页> 外文期刊>Translational behavioral medicine. >Effectiveness of clinical practice change strategies in improving dietitian care for head and neck cancer patients according to evidence-based clinical guidelines: a stepped-wedge, randomized controlled trial
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Effectiveness of clinical practice change strategies in improving dietitian care for head and neck cancer patients according to evidence-based clinical guidelines: a stepped-wedge, randomized controlled trial

机译：根据基于循证临床指南的临床实践改变课程治疗营养师护理的临床实践变更策略的有效性：一步楔形，随机对照试验

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Best practice guidelines make a number of recommendations regarding dietitian management of head and neck cancer ( HNC) patients. Randomized trials assessing the effectiveness of clinical practice change strategies for improving the nutritional management of HNC patients have not previously been conducted. The purpose of this study was to evaluate the effect of practice change strategies on improving the implementation of best practice guideline recommendations for the nutritional management of HNC patients. Four Australian radiotherapy departments participated in a stepped-wedge, randomized controlled trial. Baseline data were collected across all sites simultaneously, and the intervention was then introduced to each site sequentially, in a randomly determined order. During the intervention phase, sites received a range of supportive clinical practice change strategies to facilitate dietitian adherence to clinical practice guidelines. To assess the associated practice change by dietetic staff, we evaluated the change in implementation of six guideline recommendations for dietitians from preintervention to postintervention periods. Adherence to the clinical practice guidelines during the preintervention period was generally very low. The clinical practice change strategies significantly improved the odds of provision of four of the six guideline recommendations. The study found the intervention significantly enhanced dietitian provision of recommended care for HNC patients during the postintervention period. This finding holds clinical importance for clinician and health service effective implementation of guideline recommendations as well as HNC patient treatment outcomes.
机译：最佳实践指南对头部和颈部癌症（HNC）患者的营养管理进行了一些建议。预先进行评估临床实践变更策略的有效性的随机试验尚未进行。本研究的目的是评估实践变更策略对改善HNC患者营养管理的最佳实践指南建议的实施的影响。四个澳大利亚放射疗法部门参加了一系列楔形，随机对照试验。在所有站点上同时在所有网站上收集基线数据，然后以随机确定的顺序顺序地将干预顺序引入每个站点。在干预阶段，网站获得了一系列支持性的临床实践变革策略，以促进营养师遵守临床实践指南。为了评估饮食人员的相关实践变革，我们评估了对营养师的六项指南建议的实施变化，从营养前往初步期间。在预领取期间遵守临床实践指南通常非常低。临床实践变更策略显着提高了六项指南建议中有四项的规定的几率。该研究发现干预显着提高了营养师提供了营养师在后期患者的推荐护理。这一发现对临床医生和卫生服务有效实施指南建议以及HNC患者治疗成果的临床重要性。

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