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.

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Version: Author's accepted manuscript
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Serval ID
serval:BIB_8B15AF1E53B3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
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.
Journal
European journal of clinical nutrition
Author(s)
Grolimund Berset D., Guex E., Valentinuzzi N., Borens O., Wild P., Coti Bertrand P.
ISSN
1476-5640 (Electronic)
ISSN-L
0954-3007
Publication state
Published
Issued date
02/2019
Peer-reviewed
Oui
Volume
73
Number
2
Pages
276-283
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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).
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 (T <sub>0</sub> ) and after (T <sub>1</sub> + T <sub>2</sub> ) implementation of the nutritional policy were compared.
Ninety-eight patients were included. The nutritional care-quality indicator improved from 26 to 81% between T <sub>0</sub> and T <sub>2</sub> . During the T <sub>1</sub> and T <sub>2</sub> 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).
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.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Female, Hospital Units, Humans, Male, Middle Aged, Nutrition Assessment, Nutritional Support, Orthopedic Procedures, Pilot Projects, Postoperative Complications/prevention & control, Protein-Energy Malnutrition/prevention & control, Quality Improvement, Sepsis/prevention & control, Switzerland, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
29/10/2018 13:52
Last modification date
26/06/2020 6:21
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