title: Review of dietetic service provision and activity in spinal cord injury centres: a multicentre survey in the UK and Republic of Ireland.
abstract: OBJECTIVE
  The present study was undertaken to review the service provision in spinal cord injury (SCI) centres (SCICs); to establish and compare how much time dietitians spend in direct and indirect contact with patients; and to document current nutritional screening practices.
  
  
  METHODS
  All 12 SCICs in the United Kingdom and the Republic of Ireland were surveyed by a postal questionnaire in April 2014. Data collected included the number of whole-time-equivalent (WTE) staff available, whether a nutrition team was present and the use of nutrition screening tools. A work sampling tool was used to capture dietetic activity for a period of 1 week.
  
  
  RESULTS
  Eight (66.7%) SCICs responded (390/531 of total SCI beds) and the average numbers of patients per WTE staff, including consultants, nurses, dietitians, physiotherapists, occupational therapists were recorded. Six out of eight SCICs used a validated nutritional screening tool. Thirty-two work sampling tools were analysed, revealing that spinal dietitians spend 39.1% of the working day in direct patient-related activities. Staffing levels varied and were below clinical recommendations in six out of eight SCICs.
  
  
  CONCLUSIONS
  The resources allocated to nutritional care in SCICs appear to be varied and limited. This suggests malnutrition may continue to be under-recognised and under-treated. To address the complex nutritional needs of this special population group there is a clear need to establish staffing level for dietitians. Information collected from the present study could contribute to the supply analysis of a future workforce planning exercise in SCIC dietetic service.
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.|Health Service Management Division, School of Health Sciences, City University London, London, UK.|Institute for Liver and Digestive Health, University College London, London, UK.
authors.forename: S
authors.identifier: http://orcid.org/0000-0002-3975-5684
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: A
authors.initials: A
authors.lastname: Graham
authors.affiliation: Health Service Management Division, School of Health Sciences, City University London, London, UK.
authors.forename: S P
authors.initials: SP
authors.lastname: Hirani
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: D
authors.initials: D
authors.lastname: Charlton
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: S
authors.initials: S
authors.lastname: Coalwood
authors.affiliation: Health Service Management Division, School of Health Sciences, City University London, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: McKeown
authors.affiliation: Department of Nutrition and Dietetics, Princess Royal Spinal Injuries Centre, Northern General Hospital, Sheffield, UK.
authors.forename: C
authors.initials: C
authors.lastname: Taylor
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: M
authors.initials: M
authors.lastname: Saif
mesh_terms: D003430:Cross-Sectional Studies; D004046:Dietetics / Q000379:methods* / Q000592:standards; D005260:Female; D006282:Health Personnel; D006801:Humans; D007494:Ireland; D008297:Male; D015337:Multicenter Studies as Topic; D009752:Nutritional Status; D018529:Nutritional Support; D040841:Resource Allocation; D013119:Spinal Cord Injuries / Q000178:diet therapy* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D006113:United Kingdom