TTP3.05 Nourish to Flourish – Improving Post-Operative Nutrition as Part of Enhanced Recovery Programme at a District General Hospital

Aim To audit our compliance with nutritional recommendations in the post-operative phase of enhanced recovery (ERAS) pathway based on the 2018 ERAS Society recommendations Method First cycle of the audit included patients who underwent elective colorectal resections between January – March 2024. Data was collected on post-operative nutritional components of ERAS including resumption of oral intake and use of oral nutritional supplements (ONS), and weight loss. Educational interventions, and ‘Nutrition in Enhanced Recovery after Colorectal Surgery Guideline’ were introduced locally. Second cycle of the audit was completed between September – October 2024. Results A total of 46 patients and 20 patients were included, in cycle one and two, respectively. All patients were commenced on oral fluids from the day of surgery in both cycles. Majority were established on oral diet on day 1 of surgery (89% in cycle one and 80% in cycle two). We identified that ONS was not offered routinely as part of our institution’s ERAS programme. After cycle one, local nutritional guideline was drafted and subsequently approved at trust level, leading to the introduction of Fortisips with an uptake rate of 75% in cycle two. There is no statistically significant difference in average weight loss between cycle one (2.67kg) and cycle two (1.19kg), based on paired two-sample T test. Conclusion Most patients resumed oral intake on the day of surgery as per ERAS recommendation. Implementation of local nutritional guideline was effective in introducing post-operative ONS, although more work is required to improve its prescription.