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An investigation into the perioperative nutritional management of open colorectal surgery patients in major A ustralian hospitals: a comparison with the ERAS guidelines
Author(s) -
Wykes Katie,
Taylor Karen,
Wilkinson Shelley A.
Publication year - 2013
Publication title -
nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.479
H-Index - 31
eISSN - 1747-0080
pISSN - 1446-6368
DOI - 10.1111/1747-0080.12021
Subject(s) - guideline , medicine , colorectal surgery , clinical nutrition , acknowledgement , nursing , family medicine , surgery , abdominal surgery , pathology , computer security , computer science
Aim The present study compared the adherence of A ustralian hospitals with the ‘enhanced recovery after surgery’ guidelines for the management of colorectal surgery patients to inform development of a colorectal surgery care‐path. Methods Twelve Australian dietetic departments were approached and completed telephone interviews from J une to S eptember 2010 based on questions informed by the ‘enhanced recovery after surgery’ guidelines. Dietitians were questioned about their guideline awareness and the nutritional management of colorectal surgery patients within their facility. Current dietetic practices and perceived barriers and enablers to implementation of the ‘enhanced recovery after surgery’ guidelines were investigated. Results Dietitians at 10 of the 12 hospitals approached completed the interviews. Despite wide awareness of the ‘enhanced recovery after surgery’ nutrition guidelines in those surveyed and attempts to change practice, no hospital in the study had fully implemented the guidelines. Only three dietitians reported practising nutritional management of patients in accordance with more that half of the guideline elements. The most consistently implemented guideline element was the early removal of nasogastric tubes. The guideline element with the most reported difficulty were avoiding the use of bowel preparation and implementing preoperative carbohydrate supplementation. Recommendations have been presented to assist dietitians throughout A ustralia to close the gap between the evidence base and clinical practice. Conclusion A significant gap between the literature and clinical practice remains in the nutritional management of colorectal surgery patients. Acknowledgement of barriers and enablers to guideline implementation may assist in future guideline adoption.