Gastroenterology Registered Nurse

My topic is the use of pre-operative nutrition in clients undergoing gastrointestinal surgery. Due to the establishment of ‘Enhanced Recovery After Surgery’ that starts 24hours before surgery with enteral feeding or early oral and carbohydrates loading given to clients the day after the surgery, the topic is important as poor pre-operative nutrition is directly linked to the poorer surgical outcome and post-operative complications. Burden, Todd, Hill, and Lal (2010) explain that malnutrition or poor level of nourishment results to complications and infections after digestive system surgery. Some of the complications include bleeding, blood clots, heart failure and breakdown at the surgery site.

The following PICOT criteria will be used. The PICOT intervention was: in adults patients, pre-operative nutrition compared to no nutrition after surgery affect the nourishment level after surgery. Da Silveira, de Oliveira Carvalho, and Cataneo (2012) explain that during gastrointestinal surgery, one infection that commonly occurs is diarrhea, which is treated by alimentation and hydration. The best method known to prevent diarrhea is the use of pre-operative nutrition to maintain a proper hydration level for the patient.  

Bowel preparation is an essential intervention that assists in the detection of lesions, views cleanliness and caecal intubation success rate. Therefore, as mentioned by Zin, Min Swe, and Maw (2011), pre-operative nutrition assists in determining the cleanliness of colonic. The bowel according to Guenaga, Matos, Castro, Atallah, and Wille-Jørgensen, 2003), requires being mechanically prepared for elective colorectal surgery. If bowel contents are present during the surgery of colorectal, anastomotic leakages may occur which may be reduced by pre-operative nutrition. However, as mentioned by Zimmermann et al., (2010), patients undergoing major elective abdominal surgery may use perioperative corticosteroids as they assist in the biosynthesis of proteins.  

References

Burden, S., Todd, C., Hill, J., & Lal, S. (2010). Preoperative Nutrition in Patients Undergoing Gastrointestinal Surgery. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd008879

da Silveira, R., de Oliveira Carvalho, P., & Cataneo, A. (2012). Interventions for reducing diarrhoea in patients receiving chemotherapy for colorectal cancer. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd009615

Fineout-Overholt, & Melnyk. (2014). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (3rd ed.). Lippincott Williams & Wilkins.

Guenaga, K., Matos, D., Castro, A., Atallah, A., & Wille-Jørgensen, P. (2003). Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd001544

Zimmermann, J., Turzo, M., Roggenbach, J., Jensen, K., Diener, M., & Seiler, C. et al. (2010). Perioperative corticosteroids for patients undergoing elective major abdominal surgery (CORPUS). Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd008899

Zin, T., Min Swe, K., & Maw, M. (2011). Bowel preparation for colonoscopy. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd006330.pub2