Consider the following steps 4&5. Please help I am attaching…

Consider the following steps 4&5. Please help I am attaching…

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Answered step-by-step
Asked by ratnawalidutta

Consider the following steps 4&5. Please help I am attaching Step 1-3 below that i have already completed.

  • Identify/enroll participants. If retrospective, identify how participant data will be collected
  • Obtain/develop a data collection form (attach)
  • Provide training for anyone involved in the study
  • If appropriate, conduct a pilot study
  • Check accuracy of data collected (attach copy of raw data)

 

Step 5: Analyze and report data

  • Input data into analysis software (e.g., Excel, SPSS, SAS, etc.).Please guide asin how to do .or provide a sample.
  • Conduct statistical analyses
  • Prepare results for presentation and publication
    • Background for Project: Using a minimum of 5 references , provide a summary of the  background for conducting the project. The background should provide a summary of what is already known on the topic, what is not known (the knowledge gap that you are trying to fill), and a purpose of the study (what will be studied, including the hypothesis or objective).
    • Methods: , Include research question, research objectives, the research design, a description of the population/sample with inclusion/exclusion criteria, the detailed methods used to collect the data, and the statistical analysis used. Do not include results and be sure to write in the past tense.
    • Results: provide a narrative that includes a summary of all results. Remember, a mean needs a standard deviation, and a frequency needs a percentage. If inferential statistics are used, be sure to include p-values. Include at least 2 tables, 2 figures, or 1 table and 1 figure.
    • Conclusions:  restate the study’s original purpose and draw conclusions about the process that was researched (do not simply repeat the results). Also describe the strengths and limitations of the study/research.
    • Recommendations: , describe at least 3 recommendations to improve practice based on the results of your research. The recommendations are to improve the process, performance, or outcomes at the facility, not to improve the research methods.

Step2-

Article 1 : Stacey Uhl et.al. Interventions for malnutrition in hospitalized adults: A systematic review and meta-analysis. National Library of Medicine. PubMed. Published June 21,2022. Accessed October 4,2023.DOI: 10.1002/jhm.12891

 

Article 2: Ebony Tucker , Natalie Luscombe-Marsh , Christina Ambrosi , Kurt Lushington . Nutritional status and quality-of-life of older adults in aged care: A systematic review and meta-analysis. Science Direct. Published June 01,2022. Accessed October 4,2023. https://doi.org/10.1016/j.exger.2022.111764

 

Article 3 : Alvin Wong , Yingxiao Huang , P Marcin Sowa , Merrilyn D Banks , Judith D Bauer. Effectiveness of dietary counseling with or without nutrition supplementation in hospitalized patients who are malnourished or at risk of malnutrition: A systematic review and meta-analysis. Aspen. Journal of Parenteral and Enteral nutrition. Published May 11, 2022. Accessed October 4,2023. https://doi.org/10.1002/jpen.2395

 

 

Article 4:  Susan Felder et.al . Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. National Library of medicine . PubMed. Published December,2015. Accessed October 4,2023. https://doi.org/10.1016/j.nut.2015.06.007

 

Article 5: Lucy Lengfelder , Sarah Mahlke , Lynn Moore , Xu Zhang , George Williams 3rd , Jenny Lee . Prevalence and impact of malnutrition on length of stay, readmission, and discharge destination. Journal of Parenteral and Enteral nutrition. Published December 29, 2021. Accessed October 4,2023.

https://doi.org/10.1002/jpen.2322

 

 

Summary Of the articles above .

Article 1: This article conducted a comprehensive review of randomized controlled trials (RCTs) from January 1, 2000, to June 3, 2021, to evaluate the efficacy of hospital-initiated interventions for adults diagnosed or at risk of malnutrition. The study identified 11 relevant RCTs focusing on two intervention types: specialized nutrition care and increased protein provision. The pooled results from these trials demonstrated a moderate level of evidence indicating a 21% reduction in mortality (relative risk: 0.79) associated with these interventions. While there was a nonsignificant decrease in length of stay and a 10% reduction in readmissions, no eligible RCTs assessed parenteral or enteral nutrition. The findings suggest that specific hospital-initiated interventions, such as specialized nutrition care and increased protein provision, can significantly reduce mortality and potentially enhance the quality of life for patients at risk of or diagnosed with malnutrition.

 

Article 2:  This study delved into the relationship between malnutrition and quality of life (QoL) in older individuals residing in aged care settings, exploring studies published from 1995 to 2020. The systematic review and meta-analysis, based on 21 identified studies from databases like MEDLINE and PsycINFO, revealed a significant positive association between nutritional status and QoL in both cross-sectional and quasi-experimental studies. Furthermore, nutrition-based interventions were found to significantly improve QoL. While randomized controlled trials showed a non-significant but improved trend post-intervention, the overall findings suggest that interventions focusing on nutrition have a positive impact on the QoL of older individuals in residential aged care. The study emphasizes the need for future research to establish causality and better account for confounding factors influencing both nutritional status and QoL.

 

Article 3: This study aimed to investigate the impact of dietary counseling, with or without oral nutrition supplementation (ONS), compared to standard care, on malnourished or at-risk-of-malnutrition hospitalized adults. Sixteen studies were analyzed, and the meta-analysis revealed that dietary counseling, with or without ONS, probably does not significantly reduce 30-day inpatient mortality but slightly reduces 6-month mortality and complications. The intervention may also have a slight impact on reducing readmission rates but does not significantly reduce the length of stay. While there were improvements in nutrition status/intake and weight/body mass index, the certainty of evidence for these outcomes was low. The study suggests a positive impact of dietary counseling on outcomes and recommends focusing on standardizing counseling methods and providing details on ONS adherence to better determine the effectiveness of dietary counseling.

 

Article 4: This study conducted in a Swiss tertiary care hospital aimed to investigate the prevalence of nutritional risk and its correlation with various adverse clinical outcomes in acutely ill medical inpatients. Among 3186 patients, 27.8% were identified as at risk for malnutrition based on the Nutritional Risk Score (NRS 2002). The study found strong associations between nutritional risk and multiple adverse outcomes, including mortality, impaired activities of daily living, prolonged hospital length of stay, higher hospital readmission rates, and reduced quality of life. These associations remained significant even after adjusting for sociodemographic characteristics, comorbidities, and medical diagnoses. Subgroup analyses suggested potential variations based on age and main diagnosis groups. The conclusion emphasizes the significance of nutritional risk in acutely ill medical inpatients, highlighting the need for randomized trials to explore evidence-based preventive and treatment strategies targeting nutritional factors to improve outcomes for these high-risk patients.

Article 5: This study conducted in Houston, Texas, aimed to investigate the prevalence of malnutrition among hospitalized patients upon admission and its correlation with various factors such as length of stay, discharge disposition, and readmission rates. The research, encompassing 416 patients across nine tertiary care hospitals, revealed that 31.7% of patients were malnourished upon admission. Malnourished individuals tended to be older with a lower body mass index compared to normal nourished counterparts. The study found that malnourished patients were associated with a longer length of stay and a higher likelihood of readmission within 30 days. The modified criteria from the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition were effectively employed in the study, emphasizing the significance of addressing malnutrition in hospitalized patients.

 

Step 3

Determine the research design that will be use. Identify the intervention that will provided to the intervention group and what type of intervention (if any) will be used in the comparison group. Randomized Controlled Trial or observational study.

The intervention group will receive a comprehensive nutrition therapy program, including nutrition support, education, counseling, and oral nutrition supplements.

The comparison group will receive standard nutrition care.

Establish the necessary sample size (see table below). Describe how the sample size was determined. The sample size was determined based on the number of participants needed to achieve statistical significance and account for potential dropouts or non-compliance. A sample size of 25 participants per group is appropriate. This sample size will allow for a power of 80% and an alpha level of 0.05 to detect a medium effect size.
Describe data collection methods

Patient characteristics, how the subjects will be identified for inclusion in the research, exclusion criteria, how the intervention will be measured or evaluated, how outcomes are being measured.

Participants will be identified through MST scores and screened for eligibility criteria, which includes a diagnosis of malnutrition and being admitted to the hospital. Exclusion criteria may include individuals with certain medical conditions that may affect their nutritional status, Pregnancy or lactation, Current use of medication that might interfere with intervention, Inability to understand or consent to study. Data will be collected through chart reviews and patient interviews/questionnaires. Nutrition intake and outcomes data will be collected at admission and then every 7 days during the hospital stay. Length of stay and discharge destination data will be collected at the end of the hospital stay.
Determine the statistical analyses that will be used. List each variable that will be collected and indicate the type of descriptive statistic that will be used. Also describe any inferential statistics (e.g., t-test, ANOVA, correlation, etc.) that will be used to answer the research question(s). Variables Collected: Nutrition intake data (calories and macronutrient intake), malnutrition severity, length of stay (in ICU, Rehab, and total), discharge destination, and any adverse medical outcomes.

Mean and standard deviation will be used to describe continuous variables, such as nutrition intake and length of stay. Frequencies and percentages will be used to describe categorical variables, such as discharge destination.

Inferential Statistics: The t-test will be used to compare proportions between groups for categorical variables. Additionally, correlations may be calculated to explore relationships between variables and the impact of nutritional therapy on outcomes.

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