Post operative nutrition

Surgical procedures induce a hypermetabolic response on the body increasing protein and energy requirements. Development of post-operative malnutrition is dependent on the patients pre-existing nutritional status, the surgical procedure and the degree of hyper-metabolism. Post-operative malnutrition can impair immune function, increase mortality, increase length of stay, compromise wound healing and increase complication rates. Early enteral nutrition post-surgery reduces the risks of wound infection, pneumonia, intra-abdominal abscess and anastomotic dehiscence.

Surgery can induce the following:

• Nausea
• Vomiting
• Anorexia
• Constipation/Diarrhoea
• Stress/anxiety
• Dysphagia
• Reduced appetite
• Enforced periods of fasting

At York Teaching Hospital, NHS Foundation Trust it is hospital policy that all adult patients must have their nutritional needs assessed by nursing staff within 24 hours of admission using the Nutrition Risk Screening Tool. This falls in line with the NICE Quality Standard for Nutrition Support in Adults QS24 (2012) and is part of the CQC Guidance (Meeting Nutritional Needs).

The Nutritional Risk Screening Tool assesses:

• The patient's weight and BMI
• Weight change within the last 6 months
• The patient's current appetite and special dietary needs
• Any factors increasing nutritional requirements or affecting absorption

Patients must be re-screened weekly or more frequently if their clinical condition changes. Patients should be referred to the Dietitian if:

• Their NRS is ≥ 5 or more
• The patient requires NG/NJ/PEG/JEJ feeding
• The patient requires Total Parenteral Nutrition (TPN)

At York Teaching Hospital, referrals can be made by calling the Nutrition and Dietetics referral line on ext. 2682 or alternatively via electronic referral.