title: Pilot process and outcome evaluation of the introduction of a clinical nutrition pathway in the care of in-hospital renal patients.
abstract: OBJECTIVE
  Our objective was to investigate the effect of in-service education and the use of a clinical decision-making pathway on nurses' knowledge related to nutritional needs of renal patients and referrals to a dietitian.
  
  
  METHODS
  This was a before-and-after evaluation study of the effect of the implementation of a clinical nutrition pathway on nurses' knowledge and dietitian referrals.
  
  
  METHODS
  The setting was a renal in-patient unit in southeast Queensland, Australia.
  
  
  METHODS
  There were two groups of participants. Part 1 consisted of 53 registered nurses working in the renal unit of a regional general hospital, and Part 2 consisted of the medical records of two cohorts of more than 100 patients admitted to the renal unit.
  
  
  METHODS
  A clinical nutrition pathway and a resource package were developed to support nurses' decision-making related to the nutritional care of renal patients. Thirty-minute in-service education sessions were conducted to explain the use of the pathway, and to develop nurses' confidence in dietary decision-making for renal patients.
  
  
  METHODS
  The main outcome measures consisted of the nurses' knowledge of nutritional interventions with renal patients and the frequency of dietitian referrals.
  
  
  RESULTS
  The nurses' knowledge increased, and referrals to dietitians remained constant.
  
  
  CONCLUSIONS
  In-service education and access to unit-based resources, including a decision-support clinical nutrition pathway, improved nurses' knowledge of nutritional care for renal patients. Nurses continued to refer patients for dietitian consultation after the intervention.
authors.affiliation: Gold Coast Health Service District, Southport Campus, Queensland, Australia. Meri_Manafi@health.qld.gov.au
authors.forename: Meri
authors.initials: M
authors.lastname: Manafi
authors.forename: Paula
authors.initials: P
authors.lastname: McLeister
authors.forename: Alexander
authors.initials: A
authors.lastname: Cherry
authors.forename: Marianne
authors.initials: M
authors.lastname: Wallis
mesh_terms: D003657:Decision Making; D004046:Dietetics; D004509:Education, Nursing, Continuing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D009726:Nurses / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000592:standards*; D010353:Patient Education as Topic; D010865:Pilot Projects; D011793:Queensland; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires