Nutrition assessment and management among gastrointestinal cancer patients receiving chemotherapy in a medical oncology ward: a best practice implementation project

Abstract

Executive Summary Background Malnutrition is a growing global health problem among cancer patients receiving chemotherapy treatment. Screening for malnutrition in patients with cancer is vital for further intervention. Most clinicians commonly agree that nutrition management of gastrointestinal cancer remains insufficient. Systematic screening for malnutrition should be instituted and then appropriate and efficient nutritional support proposed if necessary. Objectives The aim of this clinical audit was to implement best practice in nutrition assessment and management among gastrointestinal cancer patients with chemotherapy in a medical oncology ward. Methods This project utilized a pre and post implementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. The audit criteria are based on available best evidence. The program was divided into three phases and was conducted over a six-month period in the Medical Oncology Ward of Fudan University Shanghai Cancer Center. Results The compliance rates of all criteria had improved in the follow-up cycle audit. The compliance rates achieved 100% in ‘validated screening tool ’, ‘screen at admission ’, ‘ patient education ’, and ‘ dietary counselling ’after the best practice implementation. Conclusions The program brought many significant changes to the Medical Oncology Ward of Fudan University Shangai Cancer Center. Clinical audit projects can facilitate evidence based practice of nutrition assessment and management among chemotherapy patients. Future strategies include testing the accuracy of the nutritional risk screening 2002 tool, and establishing better cooperation with clinicians.