Nutrition and the severe burn injured patient at the Tasmanian Burns Unit

Ms Rebecca Schrale1, Ms Kate Prins

1Tasmanian Burns Unit Royal Hobart Hospital

An audit was conducted to benchmark patient care against best practice guidelines 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 Zealand (BRANZ) 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 current Burns Nutrition Support protocol, with consensus on fasting times, recommencement of enteral nutrition post theatre, and appropriate bowel regimens for burn injured patients.

I have an endorsed Nurse Practitioner in Burns and have been employed at the Tasmanian Burns Unit for the past 16 years. I am currently the Clinical Nurse Consultant of Burns at the Tasmanian Burns Unit at the Royal Hobart Hospital.

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