Miss Kirsten Morris1, Ms Claire Reilly1
1University of Queensland, St Lucia, Australia, 2Queensland Children’s Hospital, South Brisbane, Australia
Paediatric patients with a major burn injury are at risk of poor nutritional outcomes including faltering growth and malnutrition, and therefore require intensive nutritional support. The medical records of 23 paediatric patients admitted to Queensland Children’s Hospital from January 2018 to March 2019 with a burn injury who received dietetic input were retrospectively reviewed. The purpose of the audit was to determine whether patients received nutritional care as per the hospital’s best practice guidelines. Patients with a burn injury are often unable to meet their elevated nutritional requirements orally and may require enteral nutrition. According to the best practice guidelines, enteral nutrition should be commenced between 6-12 hours post burn (Rousseau et al. 2013). For the 18 patients requiring immediate nutritional support, the average time from the patient’s admission and receiving feeds was 11.94±6.91 hours (n=18). Patients received an average of 44.08%±27.88% of their feeds in the first 24 hours. Delays in commencing feeding regimens included fasting for theatre and the medical team waiting for dietetics input. Patients were required to fast for change of dressing procedures on average 1.6±2.96 times per week, which contributed to patients receiving 66.98%±16.39% of their goal rates across their admission. Regular quality improvement audits need to be conducted in hospital burn units to identify improvements to nutritional care. The proposed quality improvement recommendations included creating a summary nutritional care resource and updating the current nutritional management guidelines for the multidisciplinary team to follow, increasing the planning of enteral feeds around fasting periods and more regular weights and heights measured during the admission.
Kirsten is a recently graduated dietitian from the Master’s of Dietetics program at the University of Queensland. In her final year, she completed a four week research project at Queensland Children’s Hospital focusing on the nutritional care for paediatric patients with a burn injury.