Improving nutritional care quality in the orthopedic ward of a Septic Surgery Center by implementing a preventive nutritional policy using the Nutritional Risk Score: a pilot study.

Septic Surgery Center (SSC) patients are at a particularly high risk of protein-energy malnutrition (PEM), with a prevalence of 35-85% found in various studies. Previous collaboration between our hospital's SSC and its Clinical Nutrition Team (CNT) only focussed on patients with severe PEM. This study aimed to determine whether it was possible to improve the quality of nutritional care in septic surgery patients with help of a nutritional policy using the Nutritional Risk Score (NRS). Nutritional practices in the SSC were observed over three separate periods: in the 3 months leading up to the implementation baseline, 6 months after implementation of preventive nutritional practices, and at 3 years. The nutritional care quality indicator was the percentage of patients whose nutritional care, as prescribed by the SSC, was adapted to their specific requirements. We determined the septic surgery team's NRS completion rate and calculated the nutritional policy's impact on SSC length of stay. Data before (T <sub>0</sub> ) and after (T <sub>1</sub> + T <sub>2</sub> ) implementation of the nutritional policy were compared. Ninety-eight patients were included. The nutritional care-quality indicator improved from 26 to 81% between T <sub>0</sub> and T <sub>2</sub> . During the T <sub>1</sub> and T <sub>2</sub> audits, septic surgery nurses calculated NRS for 100% and 97% of patients, respectively. Excluding patients with severe PEM, SSC length of stay was significantly reduced by 23 days (p = 0.005). These findings showed that implementing a nutritional policy in an SSC is possible with the help of an algorithm including an easy-to-use tool like the NRS

Prise en charge nutritionnelle d'une ascite chyleuse [Nutritional management of chylous ascitis]

L’ascite chyleuse est une cause rare d’ascite. La majorité du temps, elle résulte de la lésion d’un canal lymphatique lors d’une chirurgie digestive ou uro-génitale, plus rarement elle est la conséquence d’un obstacle au drainage du flux lymphatique (processus néoplasique). Les conséquences nutritionnelles sont graves et conditionnent le pronostic évolutif. La dénutrition est liée à l’obligation d’exclure les acides gras alimentaires pour freiner la lymphorrhée. Le diagnostic repose sur le contexte et sur l’analyse cytologique et biochimique du liquide d’ascite. Le traitement lie intimement la prise en charge de l’état nutritionnel et de la cause sous-jacente. Le recours à une alimentation orale ou à une nutrition entérale pauvre en triglycérides à chaînes longues et enrichie en triglycérides à chaînes moyennes est une option thérapeutique majeure de l’ascite chyleuse. [Chylous ascitis is a rare cause of ascitis. Most of the time, it results of retroperitoneal lymph node or duct dissection during abdominal or urological surgery; it is rarely due to lymphatic obstruction (neoplasia). Nutritional damage is major and severely impairs prognosis. Malnutrition is due to the necessity to avoid fatty acid in meal to reduce chylous leakage. Diagnosis is based on patient's clinical history and cytologic and biochemical ascitis analyses. Treatment combines the correction of nutritional status and therapy of the causative disease. Oral diet or enteral nutrition with low content of long chain triglyceride, thus enriched in medium chain triglyceride, is the major therapeutic option of chylous ascitis.]]]> Internal Medicine; Nutrition and Dietetics; Endocrinology, Diabetes and Metabolism fre oai:serval.unil.ch:BIB_EC75ED6B6D14 2022-05-07T01:29:32Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_EC75ED6B6D14 Un Cingria de plein air Maggetti, Daniel Bergé, Aline info:eu-repo/semantics/article article 2020-09-28 Littérature, no. 199, pp. 5-8 info:eu-repo/semantics/altIdentifier/isbn/978-2-200-93308-1 <![CDATA[Introduction à un dossier «Charles-Albert Cingria» coordonné par Daniel Maggetti et Aline Berg