A Texas Health Presbyterian Hospital Dallas nurse and dietitian teamed up to study the impact of nutrition screening on surgical patients’ outcomes. Through their project, the two discovered that malnutrition risk impacted surgical site infections, length of stay and non-compliance with Enhanced Recovery After Surgery (ERAS) pathways. Jemrose Bandoy, B.S.N., R.N., MSHS, MBA, CRRN, SCRN, and Brittany Sparks, RD, LD, CNSC, teamed up to complete the project on “Does Nutrition Screening Identify Surgical Patients at Risk for Post-operative Complications and Non-Compliance?,” as part of the TCU Evidence-based Practice Fellowship.
“Working with a dietitian on the project was such a good reminder that nursing cannot be successful without collaboration with other disciplines,” Jemrose said.
Participants in the project were adults having colorectal surgery using an ERAS pathway. A three-question malnutrition screening tool was used one to three weeks pre-operatively by the colorectal surgery office staff. Patients were identified as not at risk or at risk. Patients were then assessed by a registered dietitian on the first post-operative day.
“Providing early intervention by assessing the patients the day after surgery offered more information than the simple pre-surgery malnutrition screening tool,” Brittany said.
The registered dietitian assessment of malnutrition more accurately predicted outcomes, with malnutrition risk being associated with:
- Surgical site infection (of the patients who experienced a surgical site infection, 67% were identified as at risk for malnutrition)
- Length of stay (of the patients who experienced a longer length of stay, 55% were identified as at risk for malnutrition)
- Non-compliance with ERAS pathways (of the patients who were non-compliant with ERAS pathways, 59% were identified as at risk for malnutrition)
If a patient is identified as at risk for malnutrition, they may receive additional counseling by the registered dietitian, an addition of supplements, or, if needed, the addition of nutrition support such as tubefeeding. The follow-up actions taken depend on the severity of the nutrition risk and the medical course.
As a result of the project, Texas Health Dallas has implemented registered dietitian assessments on the first post-operative day for all ERAS colorectal surgery patients, which supports reliable and seamless care.
(Pictured: Nurse Jemrose Bandoy, B.S.N., R.N., MSHS, MBA, CRRN, SCRN, and Brittany Sparks, RD, LD, CNSC, teamed up to complete a project for the TCU Evidence-based Practice Fellowship.)
By Brand Experience Communications • Posted December 19, 2019
