Aim: Evidence-based guideline translation to practice has the potential to improve clinical outcomes, however, is often impaired by poor implementation. This project aimed to evaluate the implementation of the Evidence-based guidelines for the nutritional management of adult patients with head and neck cancer among Australian Dietitians providing clinical care to this population.
Methods: A questionnaire was developed, with face and content validity confirmed by an expert panel (n=13), to gauge participant perceptions of the guidelines against an implementation evaluation framework. This framework included the domains of awareness, agreement, adoption and adherence. Dietitians were invited to participate through email distribution lists by Dietitians Australia and contacting known experts in the field. Consent was implied through survey completion. Eligibility was determined by providing clinical care to this population, questionnaire completion, and prior guideline awareness. Results were analysed using descriptive statistics; with inferential analysis to determine if demographic characteristics could reveal trends in guideline use and perception.
Results: Of the 43 initial respondents, n=28 completed the questionnaire, with n=24/28 (86%) meeting full eligibility criteria. Median (range) scores for all four domains were high: awareness (4.0/5.0 (3.2-4.8)), agreement (4.4/5.0 (4.1-4.7)), adoption (3.5/5.0 (3.1-3.9)), and adherence (4.3/5.0 (4.1-4.9)). Perception of both guideline awareness and use among multidisciplinary team colleagues was lower (mean 3.2/5.0 and 3.1/5.0 respectively). Dietitians with <10 years’ experience had significantly higher perceptions of the guidelines’ ability to positively influence practice; support evidence-based practice; and enhance Dietitian credibility (p=0.04) compared with Dietitians with ≥10 years’ experience.
Conclusion: Dietitians demonstrated high rates of guideline implementation and positive perceptions for its use in clinical practice, including improved inter-professional relationships. Future implementation strategies and evaluation should expand to engage the wider multidisciplinary team and more experienced clinicians, to help bridge the dietetics evidence-to-practice gap and optimise patient outcomes.