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Clinical nutrition

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

European Journal of Clinical Nutrition volume 73, pages 276–283 (2019)Cite this article

Subjects

Abstract

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.

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Acknowledgements

We thank the patients who participated in this study for their kind cooperation. We are indebted to the nurses and dietitians of the Unit of Clinical Nutrition for their support during data collection. We thank the nursing staff from the Septic Surgery and Acute Dialysis Centers for their collaboration during data collection, especially Michel Blanchet, José Da Silva Raposo, Valérie Kern, and Anne Van Ranst. We also thank Alice Panchaud and Christine Hug for their precious help, Daniel Teta for his kind cooperation, Michel Cheseaux for his participation in the baseline audit, and Michel Roulet for supervising the study.

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Authors and Affiliations

  1. Institute for Work and Health, University of Lausanne and Geneva, Lausanne, Switzerland

    Denise Grolimund Berset & Pascal Wild

  2. Clinical Nutrition, Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland

    Esther Guex

  3. Septic Surgery Center, Lausanne University Hospital, Lausanne, Switzerland

    Nadia Valentinuzzi & Olivier Borens

  4. Department of Orthopedic Surgery and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

    Olivier Borens

  5. Clinical Nutritionist, Apples, Switzerland

    Pauline Coti Bertrand

Authors
  1. Denise Grolimund Berset
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  2. Esther Guex
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  4. Olivier Borens
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Correspondence to Denise Grolimund Berset.

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Grolimund Berset, D., Guex, E., Valentinuzzi, N. et al. 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. Eur J Clin Nutr 73, 276–283 (2019). https://doi.org/10.1038/s41430-018-0345-1

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