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  • Title: Individual and contextual factors in the Swedish Nutrition Care Process Terminology implementation.
    Author: Lövestam E, Orrevall Y, Boström AM.
    Journal: Health Inf Manag; 2024 May; 53(2):94-103. PubMed ID: 36254749.
    Abstract:
    BACKGROUND: Standardised terminologies and classification systems play an increasingly important role in the continuous work towards high quality patient care. Currently, a standardised terminology for nutrition care, the Nutrition Care Process (NCP) Terminology (NCPT), is being implemented across the world, with terms for four steps: Nutrition Assessment (NA), Nutrition Diagnosis (ND), Nutrition Intervention (NI) and Nutrition Monitoring and Evaluation (NME). OBJECTIVE: To explore associations between individual and contextual factors and implementation of a standardised NCPT among Swedish dietitians. METHOD: A survey was completed by 226 dietitians, focussing on: (a) NCPT implementation level; (b) individual factors; and (c) contextual factors. Associations between these factors were explored through a two-block logistic regression analysis. RESULTS: Contextual factors such as intention from management to implement the NCPT (OR (odds ratio) ND 15.0, 95% Confidence Interval (CI) 3.9-57.4, NME 3.7, 95% CI 1.1-13.0) and electronic health record (EHR) headings from the NCPT (OR NI 3.6, 95% CI 1.4-10.7, NME 3.8, 95% CI 1.1-11.5) were associated with higher implementation. A positive attitude towards the NCPT (model 1 OR ND 3.8, 95% CI 1.5-9.8, model 2 OR ND 5.0, 95% CI 1.4-17.8) was also associated with higher implementation, while other individual factors showed less association. CONCLUSION: Contextual factors such as intention from management, EHR structure, and pre-defined terms and headings are key to implementation of a standardised terminology for nutrition and dietetic care. IMPLICATIONS FOR PRACTICE: Clinical leadership and technological solutions should be considered key areas in future NCPT implementation strategies.
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