Congress Abstracts 2003

18

MULTIDISCIPLINARY MANAGEMENT OF CANCER-RELATED MALNUTRITION IN AN INPATIENT GASTROINTESTINAL/HEPATOBILIARY UNIT. Maria Pacis, RN, MSN, Diana Glauner, RD, and Natasha Ramrup, RN, MSN, Memorial Sloan-Kettering Cancer Center, New York, NY.

Maintaining adequate nutritional status is a serious problem affecting oncology patients. Malnutrition is a major contributor to morbidity, mortality, and decreased quality of life. Gastrointestinal (GI) and hepatobiliary (HB) cancer populations are at high risk for these problems and pose a significant challenge to healthcare providers. Understanding this complicated population can lead to effective management strategies including early nutritional screening and assessment with a well-defined nutritional plan of care. At this NCI-designated comprehensive cancer center, a multidisciplinary team including doctors, nurses, and nutritionists is committed to detecting and managing the malnourished patient with the goals of improving nutrition and enhancing quality of life.

Cancer treatments such as chemotherapy, radiation, and biotherapy administration, and surgery performed to eradicate or control malignancies increase vulnerability to malnutrition. Patients are often malnourished prior to diagnosis, with weight loss as a presenting symptom, and the aforementioned treatments can compound the effects on their nutritional status causing loss of appetite, nausea, vomiting, diarrhea, fatigue, and mucositis, leading to decreased oral intake and subsequent weight loss.

Collaboration among the healthcare team is essential in understanding the scope of the problem and formulating an action plan. The admitting nurse performs an initial assessment for such patients, which is essential for determining those at risk for malnutrition. The nutritionist gathers data from the initial nursing screen and reviews the medical record to determine the patient’s level of nutrition risk based on diagnosis, percent weight loss, and planned treatment. The patient is then interviewed to obtain an in-depth diet history, and then a nutrition care plan is instituted.

A team approach is essential in providing patients with comprehensive nutritional care and the best resources to meet their unique needs as they arise along the continuum. This presentation will: 1) provide an overview of malnutrition and its associated symptoms among GI/HB oncology patients, 2) outline the multidisciplinary plan of care for identifying and managing malnutrition, 3) describe the nurse’s role and responsibilities on the GI/HB unit, 4) describe an innovative method of meal delivery called Room Service, and 5) describe an effective patient/caregiver education plan for combating treatment or palliation malnutrition.