eP513 Assessing Parenteral Nutrition in General Surgical Patients in a Busy Teaching Hospital

Aims Early consideration for Parenteral Nutrition (PN) in general surgical patients can reduce poor surgical outcomes and length of stay. This service evaluation and audit assessed the quality of referrals for consideration of PN and the impact these have on its timely delivery. Methods A retrospective analysis was conducted of patients who were referred for PN from the General Surgery wards between 01/11/23 – 01/12/23 and compared against local nutrition standards. Results were analysed in Microsoft Excel. Results A total of 14 patients were referred for PN. Median age 75 years (28-89), median Body Mass Index 20.1 (13.7-31.2) and median hospital length of stay 30 days (6-44). The reason for gut failure was documented in all cases (nil by mouth n=8, poor oral intake n=5, vomiting n=1) and all patients had appropriate baseline bloods. Only 11/14 cases had documented weight and height and 9/14 a MUST score. Median number of days from referral to insertion of venous access was 1 (range: 0-3), Median time to being seen by PN nurse was 1 day (range: 0-2). PN was commenced in 9 or 14 patients with median duration of 4 days (range: 3-14) on PN. In 5 cases PN was not given (reason: n=4 tolerating fluids, n=1 patient refused). Conclusions A review of patients referred to the nutrition team is performed promptly despite incomplete referral documentation. Better engagement with referral pathways may reduce the number of inappropriate referrals.