Barriers and Enablers in the Implementation of a Standardised Process for Nutrition Care: Findings from a Multi-National Survey of Dietetic Professionals in 10 Countries

Background: To explore the barriers and enablers experienced by nutrition
and dietetic professionals in the implementation of the standardised Nutrition Care Process (NCP) across 10 different countries. NCP related beliefs,
motivations and values were investigated and compared.
Methods: A validated online survey was disseminated to nutrition and
dietetics professionals in 10 countries in the local language during 2017.
Cross-sectional associations and differences between countries were explored
for level of implementation, barriers/enablers and attitudes/motivation
among the respondents.
Results: Higher NCP implementation was associated with greater occurrence of enabling aspects, as well as fewer occurrences of barriers. The
most common enabler was ‘recommendation by the national dietetic
association’ (69%) and the most common barrier was ‘lack of time’
(39%). A longer experience of NCP use was associated with a more positive attitude towards all NCP aspects. Differences between countries were
identified, regarding both the occurrence of barriers/enablers and attitudes/motivations.
Conclusions: Implementation efforts need to be tailored to country-specific
contexts when implementing a new standard of care framework among
nutrition and dietetic professionals. Additional research is needed to further
assess the management and workplace strategies to support the development
of nutrition and dietetics professionals in multidisciplinary healthcare
organisations.