Accuracy and confidence of allied health assistants administering the subjective global assessment on inpatients in a rural setting: a preliminary feasibility study

作者：Newman Cristal S^*; Cornwell Petrea L; Young Adrienne M; Ward Elizabeth C; Mcerlain Annmarie L

来源：Nutrition and Dietetics, 2018, 75(1): 129-136.

DOI：10.1111/1747-0080.12370

• allied health assistant
• malnutrition
• nutrition assessment
• subjective global assessment

AimMalnutrition has a significant impact on patient outcomes and duration of inpatient stay. However, conducting timely nutrition assessments can be challenging for rural dietitians. A solution could be for allied health assistants (AHAs) to assist with these assessments. The present study aimed to assess the accuracy and confidence of AHAs trained to conduct the subjective global assessment (SGA) compared with dietitians.
MethodsA non-inferiority study design was adopted. Forty-five adult inpatients admitted to a rural and remote health service were assessed independently by both a trained AHA and dietitian within 24 hours. The order of assessment was randomised, with the second assessor blind to the outcome of the initial SGA. Levels of agreement were examined using kappa and percent exact agreement (PEA; set a priori at 80%). Rater confidence after each assessment was assessed using a 10-point scale.
ResultsAgreement for overall SGA ratings was high (kappa = 0.84; PEA 84.4%). PEA for individual sub-components of the SGA ranged from 66.4 to 86.7%. Where discrepancies were identified in global SGA ratings, AHAs provided a more severe rating of malnutrition than dietitians. AHAs reported significantly lower confidence than dietitians (t = 4.49, P < 0.001), although mean confidence for both groups was quite high (AHA=7.5, dietitians = 9.0).
ConclusionsTrained AHAs completed the SGA with similar accuracy to dietitians. Using AHAs may help facilitate timely nutrition assessment in rural health services when a dietitian is not physically present. Further investigation is required to determine the benefits of incorporating this extended role into rural and remote health-care services.

• 出版日期2018-2