Pediatric Integrated Nutrition Pathway for Acute Care Pathway (P-INPAC)
Pediatric Integrated Nutrition Pathway for Acute Care Pathway (P-INPAC): The pediatric working group of Canadian Malnutrition Task Force has developed an evidence-informed algorithm named the Pediatric Integrated Nutrition Pathway for Acute Care (P-INPAC). The P-INPAC outlines a process to improve nutrition care by:
1. implementing nutrition screening at point-of-admission
2. introducing standard care measures to prevent the development of malnutrition in children admitted with normal nutrition status, including standardizing the process of monitoring food intake early and systematically to identify when standard care measures are not sufficient
3. ensuring the moderately and severely malnourished patients receive timely specialized care in the form of a comprehensive assessment and treatment; and
4. ensuring moderately and severely malnourished patients receive adequate post discharge follow-up and nutrition care.
In this pilot study, we will be implementing the first two steps of P-INPAC only (screening and assessment).
Study summary
The framework for Pediatric Integrated Nutrition Pathway for Acute Care (P-INPAC) was developed by the Canadian Malnutrition Task Force (CMTF); however, it has not been implemented in a research setting. The framework by CMTF for Integrated Nutrition Pathway for Acute Care (INPAC) in adults was also implemented in the "More-2-Eat" project which led to development of best practices in nutritional culture of the hospitals. Therefore, we intend to undertake this feasibility project at 3-sites to train staff and evaluate the implementation of P-INPAC components as part of routine healthcare procedure.
Eligibility
Sex
ALL
Min age
30 Days
Max age
18 Years
Healthy volunteers
Accepted
Phase 1 and Phase 3 - Audited patient group inclusion Criteria:
1. ≥ 30 days of age and less than18 years of age on day of assessment
2. Anticipated Length of hospital stay ≥24 hours from day of assessment
Phase 1 \& Phase 3 Detailed patient group inclusion Criteria:
1. Admitted to either a general medical or surgical ward
2. ≥ 30 days of age and less than 18 years of age on day of assessment
3. Anticipated Length of stay ≥ 24 hours from day of assessment
4. Speak English (or French at Quebec site) or have a family proxy available at the meal to provide information if first language of patient is not English (or French at Quebec site)
5. Patient/ caregiver provides written consent to participate
Exclusion Criteria:
a. Patients with eating disorder, somatization disorders, ARFID, FORM 1 etc. where the study interaction might interfere with the messaging or therapeutic plan as set out by the responsible team.
Phase 1 and 3 for Health Care Providers inclusion criteria:
1. Implied consent to participate by completing the KAP questionnaire
2. Providing clinical service for the select ward
Primary outcome measure(s)
Baseline nutrition risk screening using STRONGkids or PNST — 2-month period (phase 1) Determine routine standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 1 of study using a validated tool, such as, STRONGkids or PNST.
Baseline nutrition risk screening using weight — 2-month period (phase 1) Determine routine standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 1 of study using routine anthropometrics - weight
Baseline nutrition risk screening using height or length — 2-month period (phase 1) Determine routine standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 1 of study using routine anthropometrics - height or length in children under 2 years of age
Baseline nutrition risk screening using head circumference — 2-month period (phase 1) Determine routine standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 1 of study using routine anthropometrics - head circumference in children under 2 years of age
Determine baseline knowledge among healthcare providers using the KAP questionnaire — 2-month period (phase 1) Determine baseline knowledge among healthcare providers on recognizing malnutrition and its management in hospitalized children, including perceived barriers and practices, using the KAP questionnaire
Determine changes in knowledge among healthcare providers using the KAP questionnaire — 4-month period (phase 3) Determine changes in knowledge among healthcare providers on recognizing malnutrition and its management in hospitalized children in Phase 3, including perceived barriers and practices, using the KAP questionnaire after training was completed in phase 2
Determine success with training and feasibility of nutrition risk screening in hospitalized children using STRONGkids and PNST — 4-month period (phase 3) Determine success with training and feasibility of implementing the P-INPAC framework by assessing changes in standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 3 of study using a validated tool, such as, STRONGkids and PNST
Determine success with training and feasibility of nutrition risk screening in hospitalized children using weight — 4-month period (phase 3) Determine success with training and feasibility of implementing the P-INPAC framework by assessing changes in standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 3 of study using routine anthropometrics - weight
Determine success with training and feasibility of nutrition risk screening in hospitalized children using height/ length — 4-month period (phase 3) Determine success with training and feasibility of implementing the P-INPAC framework by assessing changes in standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 3 of study using routine anthropometrics - height or length in children under 2 years of age
Determine success with training and feasibility of nutrition risk screening in hospitalized children using head circumference — 4-month period (phase 3) Determine success with training and feasibility of implementing the P-INPAC framework by assessing changes in standard nutritional care practices related to nutrition risk screening in hospitalized children during phase 3 of study using routine anthropometrics - head circumference in children under 2 years of age
Trial sites (3)
Facility
City
Region
Status
McMaster Children's Hospital
Hamilton
Ontario
The Hospital for Sick Children
Toronto
Ontario
Ste-Justine UHC
Montreal
Quebec
More The Hospital for Sick Children trials in Canada
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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