Exploring factors that influence the spread and sustainability of a dysphagia innovation: an instrumental case study

Table 2 Participatory Adaptation: description of the train-the-trainer intervention on the stroke and fractured neck of femur care pathways

	Stroke care pathway		Fractured neck of femur care pathway^a
	Acute Stroke	Rehab. ^c in community	Post-op^b ward	Post-op.^b ward	Rehab.^c ward	Rehab.^c in community
Staff trained as local Trainers
Number of staff	3	9 ^d	5	4	4	9^d
Designation of the trainers	2 RNs 1 OT	2 RNs 5 CSWs 2 CMs	2 RNs 2 CSWs 1H	2 RNs 2 CSWs	2 RNs 2 CSWs	2 RNs 5 CSWs 2 CMs
Follow-up support provided to the local Trainers between January–October 2013
Outreach: number of drop-in sessions	4	1 ^d	8	8	8	1^d
Feedback: verbal and written reports at half-way and end	√	√	√	√	√	√
Adaptation: additional activities	Provided staff notices about mixed diet consistencies	Joint teaching with the catering team	Prepared resource box with equipment to deliver the training Co-led a funding bid to buy specialist dysphagia and adapted crockery/cutlery			Joint teaching with the catering team
Training delivered by the trainers at Awareness and Assistant Dysphagia Practitioner levels
Formal: staff trained by ward based Trainers at 6 months	20–30 ^e	2 ^d	0	15 (Awareness level)	0	2^d
Formal: number of staff trained by 3 Education Leads^a at 10 months	-	-	Surgical Services Directorate 176 RNs 97 CSWs			-
Informal: sharing knowledge, self-report and testimony from others	√	√	√	√	√	√

^aThree Education Leads for the Surgical Services volunteered to be trained as Dysphagia Trainers. These were in addition to the ward based Trainers
^bPost-operative ward. ^cRehabilitation. ^dCommunity rehabilitation unit staff rotates between the care pathways
Abbreviations: RN registered nurse, OT occupational therapist, CSW clinical support worker, H housekeeper and, CM catering manager. ^eEstimated number (range) of stroke service staff trained by the dysphagia trainer

ISSN: 1472-6963