Nutritional screening, assessment, and management of peri-operative gastric cancer patients: a best practice implementation project
Weihua Liu, Chunyu Zhu, Wenxin Ma, Jing Li, Wei Zhang, Tingting Yang, Xiaozhen Sun, Hongmei Zhang, Yujie WangABSTRACT
Introduction:
Patients with gastric cancer in the peri-operative period often face a high risk of malnutrition, which is closely related to poor prognosis. Currently, clinical practice pays insufficient attention to this issue. The existing evidence suggests that improving the quality of nutritional screening, assessment, and management can significantly reduce the incidence of malnutrition and its related adverse outcomes.
Objectives:
This project aimed to implement evidence-based practices to improve the quality of nutritional screening, assessment, and management of peri-operative gastric cancer patients in a tertiary hospital in central China.
Methods:
This project was guided by the JBI Evidence Implementation Framework and used the JBI PACES tool to establish six review criteria for the baseline and follow-up audits. The CFIR framework was used to identify barrier factors, and the CFIR-ERIC implementation strategy matching tool was used to develop targeted strategies. Meanwhile, the GRiP method was used to organize resources and develop improvement plans. To assess the compliance of baseline and follow-up audits with best practices, this study used nursing records, medical records, and direct patient interviews as data sources.
Results:
The project led to substantial improvements in evidence-based nutritional practices. Compliance with regular nutrition screening increased from 9.4% to 96.9%, while peri-operative nutritional support rose from 6.3% to 96.9%. Additionally, the use of a validated nutrition assessment tool, quantitative nutritional evaluation, and individualized dietary support before and after surgery improved from 0% to 87.5%. Notably, the use of a validated nutrition screening tool consistently achieved a 100% compliance rate.
Conclusions:
This evidence-based practice project improved health care professionals’ compliance with best practices for nutritional screening, assessment, and management of peri-operative gastric cancer patients.
Spanish abstract:
http://links.lww.com/IJEBH/A656