Abstract
Objectives:
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.
Conclusion:
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.
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Change history
04 December 2015
This article has been corrected since advance online publication and a corrigendum is also printed in this issue.
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Acknowledgements
We are grateful to all medical staff facilitating the dissemination of study questionnaires from the UK and the Republic of Ireland. We thank Alice Defriez for reviewing the manuscript. We also thank the following persons who provided information for this study: Anthony Twist, Sian Gruffudd, Lucy Hewitson, Lorna Fitzsimons, Laura Keaskin, Philippa Bearne, Dot Tussler and Alan McLean and Liz Cole.
Author Contributions
SW was involved in protocol and questionnaire development, data analysis and manuscript preparation; AG was involved in data collection and manuscript revision; SPH was involved in questionnaire development, data analysis and manuscript revision; DC was involved in data collection and manuscript revision; SC was involved in data collection and manuscript revision; EM was involved in data analysis and manuscript revision; CT was involved in data collection and manuscript revision; MS was involved in questionnaire development, data analysis and manuscript revision. All authors contributed to the preparation of the report.
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Parts of the study data were presented at the International Spinal Cord Society Meeting in May 2015, in Montréal, Québec, Canada.
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Wong, S., Graham, A., Hirani, S. et al. Review of dietetic service provision and activity in spinal cord injury centres: a multicentre survey in the UK and Republic of Ireland. Spinal Cord 53, 855–859 (2015). https://doi.org/10.1038/sc.2015.83
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DOI: https://doi.org/10.1038/sc.2015.83
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