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Nutritional management of gastrointestinal surgical patients in Victoria's public hospitals

Barker, Lisa A. and Crowe, Timothy C. 2015, Nutritional management of gastrointestinal surgical patients in Victoria's public hospitals, Nutrition & dietetics, vol. 72, no. 3, pp. 240-246, doi: 10.1111/1747-0080.12145.

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Title Nutritional management of gastrointestinal surgical patients in Victoria's public hospitals
Author(s) Barker, Lisa A.
Crowe, Timothy C.
Journal name Nutrition & dietetics
Volume number 72
Issue number 3
Start page 240
End page 246
Total pages 7
Publisher Wiley
Place of publication London, Eng.
Publication date 2015-09
ISSN 1446-6368
1747-0080
Keyword(s) Clinical nutrition and dietetics
Evidence-based practice
Malnutrition
Science & Technology
Life Sciences & Biomedicine
Nutrition & Dietetics
RANDOMIZED CONTROLLED-TRIALS
ENHANCED RECOVERY
SURGERY
CARE
GUIDELINES
COMPLICATIONS
METAANALYSIS
MORTALITY
SUPPORT
Summary Aim: Poor nutritional status has negative effects on post-operative outcomes, further compounded by surgical stress and fasting, places gastrointestinal surgery patients at high risk of malnutrition. Recent published research has challenged historic surgical nutrition practices; however, changes to practice in Australia have been slow. The aim of this study was to investigate current nutritional management of gastrointestinal surgery patients and compare this with the best practice guidelines, while exploring enablers to implementation of best practice. Methods: A 30-question telephone survey was developed to explore demographics and nutritional management of gastrointestinal surgical patients during pre-admission, inpatient stay and post-operative care. Forty-one gastrointestinal surgery dietitians were identified and contacted from 31 public hospitals in Victoria, Australia, and invited to participate. Results: Twenty-five dietitians participated in the survey (response rate 61%). Very few dietitians (12%) were funded for pre-admission clinics or outpatient clinics, and, overwhelmingly, dietitians reported not being involved in nutritional decision-making, and reported feeling unsatisfied with current nutritional management of patients. Despite half the hospitals reporting following best practice guidelines, only 22% implemented guidelines completely. There was no correlation observed between dietitian experience, department size or full-time equivalents allocated to surgery and nutritional intervention; however, the presence of a care pathway made a significant difference to the dietitian's overall satisfaction with dietetic care (P = 0.002). Conclusions: Current nutritional management of gastrointestinal surgery patients in Victorian hospitals is far from best practice. The implementation of a care pathway is the most effective way of ensuring best practice nutritional management of gastrointestinal surgical patients.
Language eng
DOI 10.1111/1747-0080.12145
Field of Research 090899 Food Sciences not elsewhere classified
Socio Economic Objective 920411 Nutrition
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Dietitians Association of Australia
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080630

Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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