PD823 - A RETROSPECTIVE REVIEW OF ADHERENCE TO NATIONAL GUIDELINES AND TRUST POLICY AT THE ROYAL MARSDEN HOSPITAL FOR HEAD AND NECK CANCER PATIENTS RECEIVING LONG-TERM ENTERAL NUTRITION

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PD823

A RETROSPECTIVE REVIEW OF ADHERENCE TO NATIONAL GUIDELINES AND TRUST POLICY AT THE ROYAL MARSDEN HOSPITAL FOR HEAD AND NECK CANCER PATIENTS RECEIVING LONG-TERM ENTERAL NUTRITION

A. Platt1,*, F. Hammond1

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

 

Rationale: The side effects of head and neck cancer and its treatment can result in the need for long-term enteral nutrition (EN). NICE guidelines and Trust policy state these patients should be assessed and monitored by a dietitian, have a documented rationale for tube insertion, and should be considered for gastrostomy placement. This audit aimed to assess compliance with these standards.

Methods: A list of patients commencing treatment in 2024 was generated. Data was then collected retrospectively for patients requiring long-term EN, defined as more than four weeks of EN. We recorded whether patients were assessed by a dietitian before tube insertion, whether tube indication was documented, whether a gastrostomy had been considered, and whether vitamins, minerals and trace elements were monitored in patients exclusively enterally fed. Data was recorded in Microsoft Excel and then analysed.

Results: 30 patients were identified. 91% were assessed by a dietitian prior to tube insertion and 100% had a clearly documented indication for EN. 80% were considered for a gastrostomy placement. Micronutrients were measured to some degree, but there was variability in which ones were tested. No one received the level of micronutrient monitoring that is recommended in the Trust policy.

Conclusion: The main area for improvement is micronutrient testing. Implementation of a system level reminder list and a standardised blood panel would promote more consistent monitoring. Furthermore, clearer Trust policy on gastrostomy consideration for patients on long-term EN would better support dietitians in their decision-making to ensure the most appropriate tubes are used. Future audits should consider extending the data collection period and including palliative patients to capture a larger and more representative patient group.

Disclosure of Interest: None declared