Implementing a standardized nutrition protocol to enhance the nutritional health of pediatric oncology patients in the ambulatory care setting

Abstract

Background: It is estimated that 11,060 children in the United States, under the age of 15, will be diagnosed with cancer in 2019 (American Cancer Society, 2019). Malnutrition, a common consequence of the disease and its treatment, has shown to increase the risk of morbidity, mortality, early relapse, and a number of complications throughout cancer treatment. Methods: At a West Central Florida children’s hospital, a retrospective chart review was conducted pre- and post- implementation of a standardized nutrition protocol to determine percentage of compliance with the documentation of general nutrition education, monthly mid-upper arm circumference (MUAC) measurement, and monthly screening with the nutrition screening tool for childhood cancer (SCAN). In addition, percentage of parental engagement in the child’s nutritional health was determined by the completion of the CDC My Food Diary provided with specialized oncology nutrition handouts from the Academy of Nutrition and Dietetics. Results: Compliance with documentation of general nutrition education increased by 12.6%, χ2 (1, n = 45) = 1.203, 95% CI -10.71110% to 33.8141%, p = .2727. Compliance with monthly MUAC increased by 41.2%, χ2 (1, n = 45) = 10.352, 95% CI 17.33325% to 60.7465%, p = .0013. Compliance with monthly screening using SCAN was 41.2%, χ2 (1, n = 45) = 11.422, 95% CI 19.5984% to 62.2901%, p = .0007. Percentage of parental engagement with completion of the CDC My Food Diary was 0%. Implications for Practice: Monthly screening for risk of malnutrition or malnutrition allows for early intervention, potentially improving the nutritional health of children with cancer.