‘Innovative Nutrition & Swallowing Training’

1. ‘Innovative Nutrition & Swallowing Training’ Leah Platt Community Dietitian September 2011

2. Background to Project • Funded by NESC. • 7 Month project to deliver bespoke training programmes to Nursing Homes in Portsmouth City. • Joint Project between SALT (Solent Healthcare) and Dietitian (Portsmouth Hospitals NHS Trust).

3. Project Aim Reduce hospital admissions from nursing homes by enhancing local skills in identifying and managing risks of malnutrition and dysphagia. Objectives • Implement accurate ‘MUST’ screening and appropriate use of care plans • Improve the identification of dysphagia and use of safer swallowing strategies • Improve mealtime experiences

4. Project Overview Engaged stakeholders Identified / invited homes Assessed training needs Pre-training data Visited homes Developed tailored training Piloted Training Reflected & revised Delivered training

5. Practical recommendations discussed Delivered follow-up training Collected post-training data (4-6 weeks post training) Analysed and evaluated training Produce Recommendations and Publicise Findings

6. Evaluated Effectiveness Dual Professional Why was this training different? Used variety of teaching methods Engaged NH In assessment of training needs Group and Individual Training Provided tailored programmes

7. Reaction of Students Learning Behaviour Outcome Measurement: Kirkpatrick’s Training Model Did targeted outcomes improve? Results Did behaviour change? Did the trainingincrease knowledge? How did participantsreact to training?

8. Outcome: Reaction of Students Reaction of Students Learning Behaviour Results How did participants react to training?

9. Reaction from Participants • Good reaction from participants 1 2 3 4 5 4.8 • Clarity, Interest, Relevance

10. Increased Confidence - High confidence ratings for supporting residents at mealtimes both pre & post training

11. Outcome: Learning Reaction of Students Learning Behaviour Results Did the training increase knowledge, skills, attitudes, confidence, commitment?

12. Improved Knowledge

13. Reaction of Students Learning Behaviour Outcome: Behaviour Results Did behaviour change? Did people apply knowledge on the job?

14. Continued Completion of ‘MUST’ • Improved frequency of ‘MUST’completition post training • More staff involved with ‘MUST’ and care planning

15. Increased Provision of Snacks • Increased Provision of Homemade Fortified Milkshakes

16. Increased Use of Food Fortification Ingredients - Dried milk powder, condensed milk, evaporated milk, cream, cheese, butter/margarine

17. Increased Use of Fortification Ingredients

18. Improved Mealtime Practices

19. Reaction of Students Learning Behaviour Outcome: Results Did targeted outcomes improve? Results

20. In year prior to training: • 924 GP Contacts • 383 admissions to Hospital Plan to Re-Assess Next Year

21. Future Actions… • Collect GP Contacts & Hospitals Admissions Data 1Year Post Training • Nutrition & Dysphagia Link Training • 1 Day Diet Chef Course

22. Learning Points • Recognition that changes in practice requires intensive input. ? Impact on Resources • Importance of regular training • Importance of Evaluation Methods

23. Thank you for Listening