Background In 2013, we conducted a 6 month observational study (abstract CP-016 EAHP 2014) about the use of parenteral nutrition (PN) in the perioperative period in abdominal surgery. Following this study, surgeons were given specific information in order to improve prescription, and dietitians were trained to screen treatments.
Purpose This is a follow-up study. The purpose is to highlight improvements that should manifest by an increase in prescription of enteral nutrition (EN), dietitian consultations, compliance with guidelines (especially in the postoperative period) and screening malnutrition. Prescription in diverticulitis and in the postoperative period should decrease.
Material and methods Selection of patients having received PN between January and July 2014.
Retrospective analysis of medical charts by the clinical pharmacist.
Results There was an improvement in the number of patients receiving EN as well as in those having benefited from a consultation with the dietitians (figure 1).
Prescription for diverticulitis decreased in 2014 (2013, 15%; 2014, 0%). However, the postoperative indications (orange) still represented a significant proportion of patients (2013, 35%; 2014, 34%). For these patients, a 7 day postoperative period without PN should have been observed in order to comply with the guidelines. This was the case for none of the patients in 2014 (13.04% in 2013). Hence we finally see that malnutrition is well reported in 2014 (21%, 2013: 9%) (Figure 2).
Conclusion All of the goals were achieved except for those concerning postoperative PN. These observations are the result of dispensing more information about adequate use of PN and dietitian involvement. However, more information should be given about the use of postoperative PN.
References and/or Acknowledgements Espen Guidelines (Braga et al. 2009)
No conflict of interest.
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