Mrs Kate Prins1, Rebecca Schrale2
1Royal Hobart Hospital, Hobart, Australia, 2Burns Unit, Tasmanian Health Service, Hobart, Australia
An audit was conducted to benchmark patient care against best practice guidelines and other burn units around Australia with the intention that the results will form the basis of updated nutrition support protocols in the Tasmania Health Service. A retrospective medical record review was conducted for adult patients admitted to Royal Hobart Hospital (RHH) between January 2010 and December 2015 with burn injury greater than 20%. Data were extracted from both the Burns Registry of Australia and New and the RHH Digital Medical Record. Data collected included time to initiation of enteral feeding, time to goal feeding rate, number of theatre visits, fasting frequency and length, weight records and bowel management. Sixteen adult patients were admitted during the study timeframe. Findings included 69% of patients were commenced on enteral feeds within 24 hours of admission and 73% were seen by a dietitian within 48 hours. Only 12.5% of patients were weighed weekly during admission. The average time to first bowel action was 158 hours. Fasting time for each theatre visit was on average 14.2 hours and on return from theatre the feeds were only recommenced at goal rate 48% of the time. Results indicate that burn injured patients at RHH are not receiving adequate nutrition support early in their admission, which could lead to negative outcomes. This audit will be used to update the Burns nutrition support protocol, with consensus on fasting times and recommencement of enteral nutrition post theatre, as well as appropriate bowel regimens for burn injured patients.
Kate has worked as a clinical dietitian at the Royal Hobart Hospital for 10 years. Her current workload includes the intensive care unit, Burns and parenteral nutrition patients both inpatients and outpatients.