Improving nutritional care quality in the orthopedic ward of a Septic Surgery Center by implementing a preventive nutritional policy using the Nutritional Risk Score: a pilot study.
- Grolimund Berset D Institute for Work and Health, University of Lausanne and Geneva, Lausanne, Switzerland. denise.grolimund-berset@chuv.ch.
- Guex E Clinical Nutrition, Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.
- Valentinuzzi N Septic Surgery Center, Lausanne University Hospital, Lausanne, Switzerland.
- Borens O Septic Surgery Center, Lausanne University Hospital, Lausanne, Switzerland.
- Wild P Institute for Work and Health, University of Lausanne and Geneva, Lausanne, Switzerland.
- Coti Bertrand P Clinical Nutritionist, Apples, Switzerland.
- 2018-10-20
Published in:
- European journal of clinical nutrition. - 2019
Adolescent
Adult
Aged
Aged, 80 and over
Female
Hospital Units
Humans
Male
Middle Aged
Nutrition Assessment
Nutritional Support
Orthopedic Procedures
Pilot Projects
Postoperative Complications
Protein-Energy Malnutrition
Quality Improvement
Sepsis
Switzerland
Young Adult
English
BACKGROUND/OBJECTIVES
Septic Surgery Center (SSC) patients are at a particularly high risk of protein-energy malnutrition (PEM), with a prevalence of 35-85% found in various studies. Previous collaboration between our hospital's SSC and its Clinical Nutrition Team (CNT) only focussed on patients with severe PEM. This study aimed to determine whether it was possible to improve the quality of nutritional care in septic surgery patients with help of a nutritional policy using the Nutritional Risk Score (NRS).
SUBJECTS/METHODS
Nutritional practices in the SSC were observed over three separate periods: in the 3 months leading up to the implementation baseline, 6 months after implementation of preventive nutritional practices, and at 3 years. The nutritional care quality indicator was the percentage of patients whose nutritional care, as prescribed by the SSC, was adapted to their specific requirements. We determined the septic surgery team's NRS completion rate and calculated the nutritional policy's impact on SSC length of stay. Data before (T0) and after (T1 + T2) implementation of the nutritional policy were compared.
RESULTS
Ninety-eight patients were included. The nutritional care-quality indicator improved from 26 to 81% between T0 and T2. During the T1 and T2 audits, septic surgery nurses calculated NRS for 100% and 97% of patients, respectively. Excluding patients with severe PEM, SSC length of stay was significantly reduced by 23 days (p = 0.005).
CONCLUSIONS
These findings showed that implementing a nutritional policy in an SSC is possible with the help of an algorithm including an easy-to-use tool like the NRS.
Septic Surgery Center (SSC) patients are at a particularly high risk of protein-energy malnutrition (PEM), with a prevalence of 35-85% found in various studies. Previous collaboration between our hospital's SSC and its Clinical Nutrition Team (CNT) only focussed on patients with severe PEM. This study aimed to determine whether it was possible to improve the quality of nutritional care in septic surgery patients with help of a nutritional policy using the Nutritional Risk Score (NRS).
SUBJECTS/METHODS
Nutritional practices in the SSC were observed over three separate periods: in the 3 months leading up to the implementation baseline, 6 months after implementation of preventive nutritional practices, and at 3 years. The nutritional care quality indicator was the percentage of patients whose nutritional care, as prescribed by the SSC, was adapted to their specific requirements. We determined the septic surgery team's NRS completion rate and calculated the nutritional policy's impact on SSC length of stay. Data before (T0) and after (T1 + T2) implementation of the nutritional policy were compared.
RESULTS
Ninety-eight patients were included. The nutritional care-quality indicator improved from 26 to 81% between T0 and T2. During the T1 and T2 audits, septic surgery nurses calculated NRS for 100% and 97% of patients, respectively. Excluding patients with severe PEM, SSC length of stay was significantly reduced by 23 days (p = 0.005).
CONCLUSIONS
These findings showed that implementing a nutritional policy in an SSC is possible with the help of an algorithm including an easy-to-use tool like the NRS.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1038/s41430-018-0345-1
- PMID 30337712
- Persistent URL
- https://sonar.ch/global/documents/186247
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