Nutritional screening and assessment of paediatric cancer patients: A quality improvement project (baseline results)

Glatt, Dominique Ulrike; Hughes, Caoimhe; McCarthy, O.; O'Shea, Fiona; Brougham, Mark; Wilson, David C.; Iniesta, Raquel

doi:10.1016/j.clnesp.2020.04.003

Cited by 8 publications

(5 citation statements)

References 55 publications

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“…Although not the focus of this paper, there are also several QI projects aimed at malnutrition described in the pediatric oncology population 39 , 40 . Despite these examples, there is clearly a need to further emphasize QI methodologies in the care of cancer patients at risk for malnutrition.…”

Section: Utilizing Qi Principles In Malnutritionmentioning

confidence: 99%

Importance of addressing malnutrition in cancer and implementation of a quality improvement project in a gastrointestinal cancer clinic

et al. 2021

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Malnutrition is exceedingly common in cancer patients, with some of the highest rates seen in gastrointestinal (GI) malignancies. Malnutrition and cachexia in cancer patients is associated with worse quality of life, poor treatment tolerance, and increased morbidity and mortality. The importance of early recognition of malnutrition in cancer patients is key, and numerous screening tools have been validated to aid practitioners in this diagnosis. In this paper, we summarize the importance of identifying and managing malnutrition in GI cancer patients as well as its impact on clinical outcomes. We then focus on presenting our own novel quality improvement project that aims to expand access to dietitian services in a GI cancer clinic at a large safety‐net hospital system. Utilizing evidence‐based quality improvement methodologies including the Model for Improvement and Plan‐Do‐Study‐Act cycles, we increased the proportion of GI oncology patients seen by a dietitian from 5% to 20% from October 2018 to July 2019. In particular, we outline the challenges faced in the implementation process of a malnutrition screening tool built into the electronic medical record in an outpatient oncology clinic. We focus on the tool's ability to capture a greater number of patients with malnutrition and its clinical impact.

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Section: Utilizing Qi Principles In Malnutritionmentioning

confidence: 99%

Importance of addressing malnutrition in cancer and implementation of a quality improvement project in a gastrointestinal cancer clinic

et al. 2021

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“…16 Screening tools for adult patients that may be used for older teenagers and young adults include MUST (Malnutrition Universal Screening Tool) and MNA (Mini Nutrition Assessment), which are generic, 17,18 and PG-SGA (Patient-Generated Subjective Global Assessment for nutrition), which is cancer specific. 19 Previous studies both from the United Kingdom (UK) 5,[20][21][22] and elsewhere [23][24][25] have highlighted the lack of consistently applied guidance to improve nutritional screening, assessment and care in CTYA with cancer.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies both from the United Kingdom (UK) 5,20–22 and elsewhere 23–25 have highlighted the lack of consistently applied guidance to improve nutritional screening, assessment and care in CTYA with cancer.…”

Section: Introductionmentioning

confidence: 99%

Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom

Henry,

Aldiss,

Gibson

et al. 2022

Pediatric Blood & Cancer

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Background: Both under-and overnutrition may have adverse impact on outcome of cancer in children and teenagers/young adults (CTYA). Previous studies confirm that screening for nutritional risk and detection of nutritional abnormality is inconsistently undertaken in practice. Methods:We undertook a survey of dietetic resource and nutritional assessment in CTYA principal treatment centres (PTC) in the United Kingdom. Responses were received from 95% children's and 69% TYA PTC.Results: Only 13/18 (72%) children's PTC, and one of 11 (9%) TYA PTC, met national standards for dietetic resource; one of 18 (6%) paediatric and six of 11(54%) TYA PTC had no such resource. While resources were greater in larger paediatric PTC, who were also most likely to undertake stem cell transplantation, resources in TYA PTC were too low to assess relationship to centre size. Most centres focused resources on inpatient care and <50% considered staffing adequate; 82% used nutritional screening tools but without consistency in the tool used. Weight and height were the principal method for assessment, but with inconsistency in the frequency of measurement and use in different clinical settings. Measures derived from weight and height, including body mass index (BMI), were inconsistently utilised. The use of arm anthropometry was rare despite evidence that use increases recognition of undernutrition. Detailed nutritional assessment was infrequently attempted. Conclusion:Barriers to adequate nutritional assessment and treatment for all patients include resource limitations (particularly TYA), training for staff, and uncertainty about detailed assessment of nutritional status. There is a need to harmonise screening and assessment of nutritional status in CTYA with cancer.

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“…However, evidence is scarce and limited by their small sample sizes. Furthermore, most studies have focused on vitamin D [22,23], whilst other VTE, including vitamin A [14-17, 21, 24], vitamin E [14][15][16][17]21], selenium [14,15,25], zinc [14,15,19], vitamin B12 [18,24], copper [15,19] and iron/ferritin [26], have seldom been investigated.…”

Section: Introductionmentioning

confidence: 99%

“…This is particularly important since data from healthy obese children and adolescents consistently report micronutrient deficiencies, which have been attributed to a combination of high intake of energy dense foods low in vitamins and minerals, inadequate intake relative to overall body mass and alterations in micronutrient metabolism [28]. Since micronutrient concentration are rarely assessed within paediatric oncology research, the prevalence of micronutrient deficiency or excess at diagnosis and throughout treatment are relatively unknown [24].…”

Section: Introductionmentioning

confidence: 99%

Micronutrient status influences clinical outcomes of paediatric cancer patients during treatment: A prospective cohort study

et al. 2021

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Nutritional screening and assessment of paediatric cancer patients: A quality improvement project (baseline results)

Cited by 8 publications

References 55 publications

Importance of addressing malnutrition in cancer and implementation of a quality improvement project in a gastrointestinal cancer clinic

Importance of addressing malnutrition in cancer and implementation of a quality improvement project in a gastrointestinal cancer clinic

Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom

Micronutrient status influences clinical outcomes of paediatric cancer patients during treatment: A prospective cohort study

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