P331 - A PROSPECTIVE REVIEW OF ADHERANCE TO THE ROYAL MARSDEN HOSPITAL PARENTERAL NUTRITION POLICY

P331

A PROSPECTIVE REVIEW OF ADHERANCE TO THE ROYAL MARSDEN HOSPITAL PARENTERAL NUTRITION POLICY

J. Towse^1,*, B. Criswick¹, E. Kington¹, G. Hutton¹, C. Lane ¹

¹Nutrition and Dietetics, The Royal Marsden Hospital, London, United Kingdom

Rationale: Parenteral Nutrition (PN) is a costly and invasive form of nutritional support, which can increase the risk of metabolic complications if prescribed and managed inappropriately. Local policy stipulates that ‘all patients being considered for PN should be referred to a Dietitian, and documentation should include the rationale and expected duration of PN’. This audit aimed to review the rate of adherence to this policy to ensure safe multidisciplinary practice and patient care.

Methods: From March to July 2024 data was collected on all inpatients being referred for PN, by their managing Dietitian, using our electronic patient record system (EPIC). We sought to identify the percentage of cases that: had dietetic assessments prior to starting and ending PN; documented rationale and expected duration of PN; started and stopped PN within local policy. Data recorded in a Microsoft Excel spreadsheet was analysed by the auditing Dietitians.

Results: 76 patients were included. Of these, 90% had a dietetic assessment prior to starting PN but only 68% had one before ending. Most cases (86%) had the rationale for PN documented by Doctors and Dietitians but less than half (49%) had the expected duration documented. Documentation by Dietitians alone accounted for 60% and 89% respectively. Overall, adherence to local policy on both starting and stopping PN was found in 65% of cases, with better compliance in starting PN than stopping (75% vs 63%).

Conclusion: Although a small sample, evidence shows a lack of adherence to the PN policy at The Royal Marsden Hospital, particularly around Dietetic involvement in assessments and documentation of its rationale and duration. Limitations within the audit, including data collection design, warrant further investigation into the extent our policy is followed. This will better inform our new gastroenterologist consultants who will help manage and educate healthcare professionals in PN.

Disclosure of Interest: None declared