Early Nutrition Postoperative: Enhancing Recovery and Reducing Length of Stay
Problem/Purpose: Length of stay (LOS) has an average of 5.4 days in the inpatient setting and 0.1 days in the ambulatory setting. Many factors can effect a patient’s post-op LOS such as age, gender, and anesthesia type utilized. However, other factors such as early nutrition warrants further research. The research aim was to determine the association between early oral feeding and LOS among postoperative adults hospitalized within medical-surgical units at a Magnet hospital in the Southeastern United States. The overall purpose of the research study was to explore the difference in length of stay (LOS) between patients who received early oral feeding compared to patients who did not receive early oral feeding thus generating new knowledge that will promote enhancement of recovery by reducing LOS.
Methods: The study employed a quasi-experimental ex-post facto study design, using retrospective data. The instrument utilized was the Charlson Co-Morbidity Index (CCI). The CCI measures mortality risk and liability for disease. A single database was created using set variables. A CCI index score was calculated for each patient record based on ICD 10 codes for all primary and secondary diagnoses. Statistical analyses were completed using descriptive and inferential statistics. Similarities and differences in patient characteristics and in the LOS between those who were fed early and those who were not were explored. Association between LOS and other variables were examined.
Results: A total of 407 patients were included in the study. Multiple linear regression was used to model LOS as a function of age, gender, CCI, procedure type and feeding status. A unit increase in age was associated with a 0.014 days increase in LOS ( p = .041). Each unit increase in the CCI score was also associated with 0.497 days longer LOS ( p < .001). Open procedures resulted in 1.3 days longer LOS compared with laparoscopic procedures ( p < .001). The results showed no significant association between early feeding and LOS. However, it was noted that patients with early feeding had a lower LOS ( Median = 2.00, IQR = 1.00 – 3.00) compared with those fed later ( Median = 3.00, IQR = 2.00 – 3.50).
Conclusion/Implications for Practice: Although early feeding was not statistically significant, a decrease in LOS was noted. The implications surrounding LOS are profound for healthcare organizations and patients. Nurses can enhance the recovery period for post-op patients and decrease LOS by promoting early oral feeding.
14th Annual BHSF Research Conference
Grayson, Vivien; McCue, Victoria; and Adefisoye, James, "Early Nutrition Postoperative: Enhancing Recovery and Reducing Length of Stay" (2019). All Publications. 3281.