Collaboration with dietary services incorporates nutritional status into patient assessment

ANAHEIM, CALIFORNIA—A pilot program was successful in training oncology nurses to identify meaningful changes in a patient’s nutritional status and appropriately refer patients for nutrition intervention, according to a speaker at the Oncology Nursing Society (ONS) 39th Annual Congress.

Positive clinical and patient outcomes have been linked to adequate nutrition for cancer patients, and weight loss indicates compromised nutritional status that can negatively impact recovery. Achieving good nutritional status during cancer treatment requires early intervention.

Oncology nurses are well positioned to assess the nutritional status of patients while administering chemotherapy, so Nida Torres, RN, MSN, OCN®, and colleagues at the Uni­versity of Arizona Cancer Center at St. Joseph’s Hospital and Medical Center, in Phoenix, Arizona, collaborated with clinical nutritionists at the facility to develop a pilot program to determine ways to identify meaningful changes in a patient’s nutritional status and to refer those patients who needed nutrition intervention.

The pilot program was based on the Academy of Nutrition and Dietetics Oncology Toolkit. Key elements from the screening criteria of the tool were consolidated and incorporated into the computerized daily nursing assessment. Referrals to the dietitian were prompted from the electronic record. Monthly audits were conducted to determine how many referrals the program was generating.

During the first 5 months of this pilot project, the number of nutrition referrals from the infusion center increased. Thirty-two patients who met risk criteria were referred to the dietician; 26 patients (81%) had a measurable improvement in their nutritional status as a result of their referrals. Three patients had disease progression and did not improve.

The researchers reported that the pilot program successfully identified at-risk patients and allowed nurses to make appropriate referrals for nutrition intervention. Torres stated that the collaboration improves patients’ nutritional status by effectively using the resources of the nursing staff and nutrition professionals. Future plans include expanding the program to include patients undergoing treatment on the radiology service.

REFERENCE

Torres N, Siminski I, Renda L, Gruber-Page M. A pilot to determine the effectiveness of integrating nutrition screening and referral into the nursing assessment process. Presented at: Oncology Nursing Society (ONS) 39th Annual Congress; May 1-5, 2014; Anaheim, CA.