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. 2020 Jul 24;8(3):227. doi: 10.3390/healthcare8030227

Table 5.

Summary of abstracts identified through a research review of malnutrition and nutrition-focused quality improvement program (QIPs) and quality effectiveness process initiatives in cancer care.

Publication Type and Cancer Diagnosis Title Methodology Conclusions
Article
Head and neck cancer		 Evaluating the effectiveness of a nutrition assistant role in a head and neck cancer clinic [42]

  • Evaluated the effectiveness of nutrition assistant performing screening/intervention in multidisciplinary head and neck clinic

  • Provided training to nutrition assistants

  • Compared outcomes between pre- and post-implementation of nutrition assistant role

  • Nutrition assistant roles resulted in improved patient satisfaction, maintenance of nutritional outcomes, and demonstrated effectiveness of role in supporting management of head and neck cancer patients within multidisciplinary treatment clinic
Conference abstract
Neuroendocrine tumor (NET)		 Evaluation of nutritional deficiencies in a new gastroenterology-led South Wales neuroendocrine tumor (NET) service [43]

  • Retrospective study with data collected from medical records of 99 patients who attended new gastroenterology-led service

  • Compared data to 67 consecutive patients from previous service without gastroenterology input

  • Assessment addressing nutrition deficiencies was improved in new South Wales NET service incorporating gastroenterology

  • Some assessments could be improved by increased dietitian involvement
Conference abstract
Gastrointestinal (GI) cancer		 A nutrition-focused quality improvement program to improve rate of documented nutrition plan at a safety-net hospital gastrointestinal (GI) oncology clinic [41]

  • Aimed to increase documented Registered Dietitian Nutritionist (RDN) nutrition assessment from 7% to 25%

  • Arranged multidisciplinary sessions with healthcare team to identify barriers to nutritional interventions for GI oncology clinic patients

  • Carried out Plan Do Study Act (PDSA) cycles as part of nutrition-focused QI program

  • Doubled rate of documented nutritional plan for Parkland Health and Hospital System GI cancer patients within month of starting second PDSA cycle intervention
Conference abstract
Gastrointestinal (GI) cancer		 Development of a nutrition-focused quality improvement program for new patients with cancer seen at the UTSW Simmons Comprehensive Cancer Center (SCCC) outpatient gastrointestinal (GI) oncology clinic [40]

  • Aimed to increase rate of documented clinical dietitian nutrition assessment to 65% within 90 days of new patient encounter

  • Obtained baseline data from electronic medical record

  • Arranged group sessions to apply quality improvement (QI) methodologies to determine steps to clinical dietitian documented nutritional plan

  • Interviewed patient advocates to assess patient perspective

  • Planned sequential PDSA cycles to improve rates of nutrition plan documentation; data obtained every 2 weeks

  • After first PDSA cycle, early 2-week assessment showed 28% documented rate of nutritional plan; this should increase with longer follow-up and subsequent PDSA cycles

  • Malnutrition in GI cancer is prevalent and under-recognized in routine clinical encounters

  • Addressing malnutrition is important from patient perspective
Conference abstract
Not specified		 Onconut®: Nutritional care optimization for cancer patients [44]

  • Aimed to observe if European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines and best nutritional practices are followed

  • Completed three consecutive 6-month descriptive studies:
    • ○
      Analysis of current practice compliance to ESPEN guidelines (OncoNut® Day 1)
    • ○
      Best nutritional practices creation and implementation
    • ○
      Compliance evaluation after implementation (OncoNut® Day 2)

  • OncoNut® is successful experience of multidisciplinary care and has been well accepted

  • Nutrition Risk Screening 2002 (NRS-2002) evaluation is more complicated than expected for non-nutritionists; thus, training actions are required to improve nutritional screening
Conference abstract
Lung cancer		 Evaluation of an evidence-based nutrition care pathway for lung cancer patients undergoing radiotherapy [45]

  • Aimed to evaluate compliance with each component of lung nutrition care pathway and make recommendations for improvement

  • Conducted retrospective audit on 29 patients commencing radical radiotherapy

  • Examined compliance with patient screening, timing of first contact, Patient-Generated Subjective Global Assessment (PG-SGA) completion, and post-treatment follow up

  • To improve compliance, feedback was provided to nutrition department and is to be presented to multidisciplinary team to improve awareness

  • To increase completion of PG-SGA in final week, forms are now being attached to outpatient notes

  • To improve follow-up post-treatment, dietitian reviews are recommended to be scheduled together with post radiotherapy medical review

  • Ongoing monitoring and regular evaluation of the pathway is recommended
Conference abstract
Not specified		 Nutrition assistants and malnutrition in a cancer setting: Exploring an integrated model of care [46]

  • Aimed to evaluate effectiveness of nutrition assistant role within new malnutrition screening, assessment, and treatment model for inpatients

  • Developed nutrition assistant position and competency training program

  • Collected baseline data on adherence to model of care, malnutrition screening, and nutrition department activity and compared to post-implementation data

  • Nutrition assistant role can be effectively established in inpatient cancer setting

  • Nutrition assistants were highly satisfied and confident in their role after completing in-house training program

  • Results indicate that this role can assist in favorable patient outcomes and effective workforce planning