TPW 7.20 Closed Loop Audit: Assessing Parenteral Nutrition in General Surgical Patients in A Busy Teaching Hospital

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ID: 324081
2026
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Abstract
Abstract Aims Early consideration for Parenteral Nutrition (PN) in general surgical patients can reduce poor surgical outcomes and hospital length of stay (HLOS). This quality improvement project and audit assessed the quality of referrals for PN and the on impact timely delivery. The first cycle was presented at ASGBI 2025 (EP513). Methods A retrospective review was undertaken of patients referred for PN from General Surgery wards between 01/11/23–01/12/23 and re-audited in 2024. Data were compared against local nutrition standards and analysed using Microsoft Excel. Results Fourteen patients were referred in 2023 and eighteen in 2024. 20232024Median Age (range)75 years (28-89)67.5 years (24-80)Median BMI (range)20.1 (13.7-31.2)31.4 (17.3-54.3)Median HLOS (range)30 days (6-44)17 days (7-38) All cases across both cycles had a documented reason for gut failure (nil by mouth, poor intake, or vomiting) and appropriate baseline blood tests. Documentation improved by 4% in recorded height and weight (from 11/14 to 15/18) and by 30% in documented MUST scores (from 9/14 to 17/18). Median time from referral to venous access was 1 day, and all patients were reviewed by the PN nurse within 1 day, compared to a median of 1 day (0–2) previously. Rejected referrals decreased by 53%, PN commencement improved by 19% (from 9/14 to 15/18) and median duration increasing from 4 to 6 days. Conclusions Referral quality has significantly improved, allowing earlier and more appropriate nutrition, with an associated reduction in hospital length of stay.
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Authors Zion Hwang, Jayan George, Limeng Zhu, Shoieb Mridha, M C Britton, Tim Wilson
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.389
URL
https://doi.org/10.1093/bjs/znag087.389
Keywords Keywords not found

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