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

摘要

Aim Malnutrition 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 AHA s trained to conduct the subjective global assessment ( SGA ) compared with dietitians. Methods A 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. Results Agreement 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). Conclusions Trained 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.