Dietary Restrictions for Neutropenic Patients

Transcription

1 Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Dietary Restrictions for Neutropenic Patients Stephanie Baunach BSN, RN Lehigh Valley Health Network Amanda Bodnar BSN, RN Lehigh Valley Health Network Arielle Combs BSN, RN Lehigh Valley Health Network Follow this and additional works at: Part of the Nursing Commons Published In/Presented At Baunach, S., Bodnar, A., Combs, A. (2014, July 18). Dietary Restrictions for Neutropenic Patients. Poster presented at LVHN UHC/ AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA. This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org.

2 Dietary Restrictions for Neutropenic Patients Arielle Combs, RN, BSN Stephanie Baunach, RN, BSN Amanda Bodnar, RN, BSN

3 Background/Significance The neutropenic diet has been implemented since the 1960 s and greatly decreases patient satisfaction. Implementation and regulations regarding the diet are not standardized.

4 PICO QUESTION In neutropenic patients, does traditional dietary restrictions reflect evidence based practice? P- Neutropenic patients I- Revised dietary restrictions C- Traditional dietary restrictions O- Reflect evidence based practice

5 TRIGGER? Triggers New research There is no evidence to support the use of a neutropenic diet Philosophies of care Neutropenic diet decreases the rate of patient satisfaction and quality of life

6 Search Engines CINAHL EBSCOhost PubMed Key Words Neutropenic Diet Oncology Satisfaction Infection EVIDENCE

7 EVIDENCE Current rationale for this diet dates back to the 1960 s and 1970 s, which calls in to question validity of this diet due to outdated information. (Jubelier 2011) The efficacy of the neutropenic diet has not been proven and patient satisfaction rates are decreased when following the neutropenic diet. There is no substantial difference in infection rates between a restricted and unrestricted diet.

8 Current Practice at LVHN There is no standardized diet order for neutropenic patients at LVHN. It is still common practice at LVHN to educate patients regarding handling of foods and basics of the neutropenic diet.

9 IMPLEMENTATION Educate the health care team about current research regarding neutropenic diets. Collaborate with dietary to update neutropenic diet regulations.

10 Practice Change No longer educating patients regarding traditional neutropenic diet. Educate about basic food handling.

11 RESULTS Findings: No evidence supports the use of traditional neutropenic diet. Next step: Implement modifications in daily patient care. Continue to educate health care team regarding research findings.

12 Implications for LVHN Increase patient satisfaction and HCAP scores. Improve overall patient outcomes. Healthcare team implementing the most current practice standards.

13 Strategic Dissemination of Results Educate the healthcare team Collaborate with nutrition to standardize neutropenic dietary teaching within LVHN. satisfaction and quality of life.

14 Lessons Learned It is important to base clinical practice off of evidence-based research. Nurses should advocate for their patients in order to improve patient satisfaction and quality of life.

15 References DeMille, D., Deming, P., Lupinacci, P., & Jacobs, L. A. (2006). The Effect Of The Neutropenic Diet In The Outpatient Setting: A Pilot Study. Oncology Nursing Forum, 33(2), Duffy, Lisa. "Care of immunocompromised patients in hospital." Nursing Standard (2009): Gardner, A., Mattiuzz, G., Faderl, S., Borthakur, G., Garcia-Manero, G., Pierce, S., Brandt, M., Elihu Estey, E. (2008). Palliative and Supportive Care: Randomized Comparison of Cooked and Noncooked Diets in Patients Undergoing Remission Induction Therapy for Acute Myeloid Leukemia. Journal of Clinical Oncology, 26(35), Jubelirer, Steven J (2011). The Benefit of Neutropenic Diet: Fact or Fiction?; The Oncologist, 16(5): Published online Apr 6, doi: /theoncologist

16 References Restau, Jame, and Angela Clark. "The Neutropenic Diet: Does the Evidence Support this Intervention?." Clinical Nurse Specialist 22.5 (2008): Tarr, Sarah, and Deborah Allen. "Evidence Does Not Support the Use of a Neutropenic Diet." Clinical Journal of Oncology 13.6 (2009): van Dalen, E. (2012). Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia. Cochrane Database Of Systematic Reviews, (9), doi: / cd pub2 Zitella, Laura, Barb Holmes-Gobel, and Colleen O'Leary. "Updated Oncology Nursing Society Putting Evidence Into Practice Resources." Clinical Journal of Oncology Nursing 13.2 (2009):

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