Preventing Malnutrition and Restoring Nutritional Status in Hospitalized Children

Study Overview
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Brief Summary
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This cluster-randomized trial will evaluate the impact of a multifaceted intervention (including electronic medical alerts) coordinated by a Nutritional Support Team, on adherence to recommended practices for care of starved children, among health personnel of a large university hospital. A key component of the study is to assess whether improved adherence to guidelines leads to a reduction in rates of complications.

Official Title
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Developing an Organization to Improve the Screening and Care of Starved Children in Hospital

Conditions
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Nutrition Disorders

Intervention / Treatment
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* Procedure: Access to a Computerized Clinical Decision Support System (CCDDS)
* Behavioral: Education of Healthcare workers
* Other: Local assistance by a dietician


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: medical and surgical units in a large teaching hospital providing pediatric acute care. any hospital staff with direct patient care who are affiliated with a single unit (includes physicians, nurses, nursing assistants, physiotherapists, dieticians. all children recorded as malnourished at their entrance in hospital Exclusion Criteria: neonatal and intensive care units. any hospital staff with direct patient care who are not affiliated with a single unit. age under one month, liver or kidney abnormalities, severe heart failure, stay less than 2 days.

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Nutritional Support Team<br> | Procedure: Access to a Computerized Clinical Decision Support System (CCDDS)<br>* Automatic CCDSS will alert physician for each case of malnourished using an algorithm based on age, sex, weight and size of each hospitalized children.<br>Behavioral: Education of Healthcare workers<br>* Education of the hospital staff to evidence-based practices in malnutrition care will be proposed in the experimental arm. Specific training will be targeted on participants according to their function.<br>Other: Local assistance by a dietician<br>* Assistance will be conducted locally by a local dietician. Periodic multidisciplinary meetings will be attended by the hospital staff belonging to the intervention arm, including the analysis of clinical incidents related to nutrition care.<br>|
| Active Comparator: Usual care<br> | Procedure: Access to a Computerized Clinical Decision Support System (CCDDS)<br>* Automatic CCDSS will alert physician for each case of malnourished using an algorithm based on age, sex, weight and size of each hospitalized children.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence to recommended practices (including weigh in, physiotherapy, nutrition survey and monitoring) |  | At least 2 days depending on the hospitalisation time | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of complications |  | At least 2 days depending on the hospitalisation time | 
| Nutritional status evolution |  | At least 2 days depending on the hospitalisation time | 
| Mean length and cost of stay |  | At least 2 days depending on the hospitalisation time | 
| Appropriate call-in Nutritional Support Team |  | At least 2 days depending on the hospitalisation time | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Non MeSH terms:, Children, Malnutrition, Computer Clinical Decision Support System, Cluster randomized trial, Healthcare workers, Guideline adherence, Patient safety, MeSH terms:, Nutrition Surveys, Secondary Prevention, Pediatrics, Child Care, Health Personnel, Reminder Systems, Intervention Studies, Quality of Health Care