Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2017

Open Access 01-12-2017 | Research article

Hospital staffs’ perceptions of an electronic program to engage patients in nutrition care at the bedside: a qualitative study

Authors: Shelley Roberts, Andrea Marshall, Wendy Chaboyer

Published in: BMC Medical Informatics and Decision Making | Issue 1/2017

Login to get access

Abstract

Background

Advancements in technology are enabling patients to participate in their health care through self-monitoring and self-management of diet, exercise and chronic disease. Technologies allowing patients to participate in hospital care are still emerging but show promise. Our team is developing a program by which hospitalised patients can participate in their nutrition care. This study explores hospital staffs’ perceptions of using this technology to engage patients in their care.

Methods

This qualitative study involved semi-structured interviews with hospital staff providing routine nutrition care to patients (i.e. dietitians, nutrition assistants, nurses, doctors and foodservice staff) from five wards at a tertiary metropolitan teaching hospital in Australia. The hospital currently uses an electronic foodservice system (EFS) for patient meal ordering, accessed through personal screens at the bedside. Participants were shown the EFS program on an iPad and asked about their perceptions of the program, with questions from a semi-structured interview guide. Staff were interviewed individually or in small focus groups. Interviews lasted 15–30 min and were audio recorded and later transcribed. Data were analysed using thematic analysis.

Results

Nineteen staff participated in interviews. Overall, they expressed positive views of the EFS program and wanted it to be implemented in practice. Their responses formed three themes, each with a number of subthemes: 1) Enacting patient participation in practice; 2) Optimising nutrition care; and 3) Considerations for implementing an EFS program in practice. Staff thought the program would improve various aspects of nutrition care and enable patient participation in care. Whilst they raised some concerns, they focused on overcoming barriers and facilitating implementation if the program were to be adopted into practice.

Conclusions

Staff found an EFS program designed to engage patients in their nutrition care acceptable, as they saw benefits to using it for both patients and staff. Staff recognised characteristics of the program itself, as well as allocation of roles and responsibilities in operationalising it, were pivotal for successful implementation in practice. Their perspectives will inform program and intervention design, and implementation and evaluation strategies.
Appendix
Available only for authorised users
Literature
1.
Demiris G, Afrin LB, Speedie S, Courtney KL, Sondhi M, Vimarlund V, et al. Patient-centered applications: use of information technology to promote disease management and wellness. A white paper by the AMIA knowledge in motion working group. J Am Med Inform Assoc. 2008;15:8–13.CrossRefPubMedPubMedCentral
2.
Buys R, Claes J, Walsh D, Cornelis N, Moran K, Budts W, et al. Cardiac patients show high interest in technology enabled cardiovascular rehabilitation. BMC Med Inform Decis Mak. 2016;16:95.CrossRefPubMedPubMedCentral
3.
Broekhuizen K, Kroeze W, van Poppel MN, Oenema A, Brug J. A systematic review of randomized controlled trials on the effectiveness of computer-tailored physical activity and dietary behavior promotion programs: an update. Ann Behav Med. 2012;44:259–86.CrossRefPubMedPubMedCentral
4.
Connelly J, Kirk A, Masthoff J, MacRury S. The use of technology to promote physical activity in type 2 diabetes management: a systematic review. Diabet Med. 2013;30:1420–32.CrossRefPubMed
5.
Sawesi S, Rashrash M, Phalakornkule K, Carpenter JS, Jones JF. The impact of information technology on patient engagement and health behavior change: a systematic review of the literature. JMIR Med Informatics. 2016;4:1.CrossRef
6.
Prey JE, Woollen J, Wilcox L, Sackeim AD, Hripcsak G, Bakken S, et al. Patient engagement in the inpatient setting: a systematic review. J Am Med Inform Assoc. 2014;21:742–50.CrossRefPubMed
7.
Roberts S, Chaboyer W, Gonzalez R, Marshall A. Using technology to engage hospitalised patients in their care: a realist review. BMC Health Serv Res. 2017;17:388.
8.
Cook DJ, Manning DM, Holland DE, Prinsen SK, Rudzik SD, Roger VL, et al. Patient engagement and reported outcomes in surgical recovery: effectiveness of an e-health platform. J Am Coll Surg. 2013;217:648–55.CrossRefPubMed
9.
Cook DJ, Moradkhani A, Douglas KSV, Prinsen SK, Fischer EN, Schroeder DR. Patient education self-management during surgical recovery: combining mobile (iPad) and a content management system. Telemed e-Health. 2014;20:312–7.CrossRef
10.
Bickmore TW, Mitchell SE, Jack BW, Paasche-Orlow MK, Pfeifer LM, O’Donnell J. Response to a relational agent by hospital patients with depressive symptoms. Interact Comput. 2010;22:289–98.CrossRefPubMedPubMedCentral
11.
Bickmore TW, Pfeifer LM, Jack BW. Taking the time to care: empowering low health literacy hospital patients with virtual nurse agents. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. Boston: ACM; 2009.
12.
Oosterom-Calo R, Abma TA, Visse MA, Stut W, te Velde SJ, Brug J. An interactive-technology health behavior promotion program for heart failure patients: a pilot study of experiences and needs of patients and nurses in the hospital setting. JMIR Res Protocols. 2014;3(2):e32.
13.
O’Leary KJ, Lohman ME, Culver E, Killarney A, Smith GR, Liebovitz DM. The effect of tablet computers with a mobile patient portal application on hospitalized patients’ knowledge and activation. J Am Med Informatics Assoc. 2016;23(1):159–65.
14.
Vawdrey DK, Wilcox LG, Collins SA, Bakken S, Feiner S, Boyer A, et al. A tablet computer application for patients to participate in their hospital care. In: AMIA annual symposium proceedings. Am Med Informatics Assoc. 2011;2011:1428–35.
15.
Wilcox L, Woollen J, Prey J, Restaino S, Bakken S, Feiner S, et al. Interactive tools for inpatient medication tracking: a multi-phase study with cardiothoracic surgery patients. J Am Med Inform Assoc. 2016;23:144–58.CrossRefPubMedPubMedCentral
16.
Weingart SN, Zhu J, Chiappetta L, Stuver SO, Schneider EC, Epstein AM, et al. Hospitalized patients’ participation and its impact on quality of care and patient safety. Int J Qual Health Care. 2011;23(3):269–77.
17.
Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Library. 2012. doi:10.​1002/​14651858.​CD003267.​pub2.
18.
Pedersen PU. Nutritional care: the effectiveness of actively involving older patients. J Clin Nurs. 2005;14:247–55.CrossRefPubMed
19.
Roberts S, Desbrow B, Chaboyer W. Feasibility of a patient-centred nutrition intervention to improve oral intakes of patients at risk of pressure ulcer: a pilot randomised control trial. Scand J Caring Sci. 2016;30(2):271–80.
20.
Agarwal E, Miller M, Yaxley A, Isenring E. Malnutrition in the elderly: a narrative review. Maturitas. 2013;76:296–302.CrossRefPubMed
21.
Ray S, Laur C, Golubic R. Malnutrition in healthcare institutions: a review of the prevalence of under-nutrition in hospitals and care homes since 1994 in England. Clin Nutr. 2014;33:829–35.CrossRefPubMed
22.
Barker LA, Gout BS, Crowe TC. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health. 2011;8:514–27.CrossRefPubMedPubMedCentral
23.
Lim SL, Ong KCB, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31:345–50.CrossRefPubMed
24.
25.
Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.
26.
Yen P-Y, Bakken S. Review of health information technology usability study methodologies. J Am Med Inform Assoc. 2012;19:413–22.CrossRefPubMed
27.
Karsh B. Beyond usability: designing effective technology implementation systems to promote patient safety. Qual Safety Health Care. 2004;13:388–94.CrossRef
28.
Sahlsten M, Larsson I, Sjostrom B, Plos K. An analysis of the concept of patient participation. Nurs Forum. 2008;43:2–11.CrossRefPubMed
29.
Kushniruk A. Evaluation in the design of health information systems: application of approaches emerging from usability engineering. Comput Biol Med. 2002;32:141–9.CrossRefPubMed
30.
Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15:398–405.CrossRefPubMed
31.
Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentral
32.
Phillips CJ, Marshall AP, Chaves NJ, Jankelowitz SK, Lin IB, Loy CT, et al. Experiences of using the theoretical domains framework across diverse clinical environments: a qualitative study. J Multidiscip Healthc. 2015;8:139–46.PubMedPubMedCentral
33.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
34.
Agoritsas T, Heen AF, Brandt L, Alonso-Coello P, Kristiansen A, Akl EA, et al. Decision aids that really promote shared decision making: the pace quickens. BMJ. 2015;350:g7624.
35.
Roshanov PS, Fernandes N, Wilczynski JM, Hemens BJ, You JJ, Handler SM, et al. Features of effective computerised clinical decision support systems: meta-regression of 162 randomised trials. BMJ. 2013;346:f657.
36.
37.
Rogers EM. Diffusion of innovations. New York: Schuster; 1995.
38.
Cresswell K, Sheikh A. Organizational issues in the implementation and adoption of health information technology innovations: an interpretative review. Int J Med Inform. 2013;82:e73–86.CrossRefPubMed
39.
Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989;13:319–40.CrossRef
40.
Gagnon M-P, Desmartis M, Labrecque M, Car J, Pagliari C, Pluye P, et al. Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals. J Med Syst. 2012;36:241–77.CrossRefPubMed
41.
Melas CD, Zampetakis LA, Dimopoulou A, Moustakis V. Modeling the acceptance of clinical information systems among hospital medical staff: an extended TAM model. J Biomed Inform. 2011;44:553–64.CrossRefPubMed
42.
Chow SKY, Chin W-Y, Lee H-Y, Leung H-C, Tang F-H. Nurses’ perceptions and attitudes towards computerisation in a private hospital. J Clin Nurs. 2012;21:1685–96.CrossRefPubMed
43.
May CR, Mair F, Finch T, MacFarlane A, Dowrick C, Treweek S, et al. Development of a theory of implementation and integration: normalization process theory. Implement Sci. 2009;4:29.
44.
Bamford C, Heaven B, May C, Moynihan P. Implementing nutrition guidelines for older people in residential care homes: a qualitative study using normalization process theory. Implement Sci. 2012;7:106.CrossRefPubMedPubMedCentral
45.
Finch TL, Mair FS, May C. Teledermatology in the U.K.: lessons in service innovation. Br J Dermatol. 2007;156(3):521–27.
46.
Irizarry T, Dabbs AD, Curran CR. Patient portals and patient engagement: a state of the science review. J Med Internet Res. 2015;17.
47.
Bonilla C, Brauer P, Royall D, Keller H, Hanning RM, DiCenso A. Use of electronic dietary assessment tools in primary care: an interdisciplinary perspective. BMC Med Informatics Decis Mak. 2015;15:14.CrossRef
Metadata
Title
Hospital staffs’ perceptions of an electronic program to engage patients in nutrition care at the bedside: a qualitative study
Authors
Shelley Roberts
Andrea Marshall
Wendy Chaboyer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2017
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-017-0495-4

Other articles of this Issue 1/2017

BMC Medical Informatics and Decision Making 1/2017 Go to the issue

Research article

“Provoking conversations”: case studies of organizations where Option Grid™ decision aids have become ‘normalized’

Research article

Information needs for making clinical recommendations about potential drug-drug interactions: a synthesis of literature review and interviews

Research article

Development of an algorithm for determining smoking status and behaviour over the life course from UK electronic primary care records

Research Article

Utility-preserving anonymization for health data publishing

Research article

Renal transplant patient acceptance of a self-management support system

Research article

Internet use, eHealth literacy and attitudes toward computer/internet among people with schizophrenia spectrum disorders: a cross-sectional study in two distant European regions