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Implementing and sustaining an evidence-based nutrition service in a haematology unit for autologous stem cell transplant patients

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Abstract

Purpose

Effective, timely and evidence-based nutritional management is important in patients receiving autologous haematopoietic stem cell transplant (HSCT) to prevent the negative consequences of developing malnutrition. This study describes a robust process for development and implementation of an evidence-based nutrition care pathway for HSCT patients in a tertiary cancer centre.

Methods

A comprehensive review of the literature was completed to identify relevant articles and evidence-based guidelines to inform the development of the pathway. Evidence from the literature review was assessed and utilised to underpin the development of pathway. The pathway was implemented in the haematology service in collaboration with the multidisciplinary haematology team. Dietetic resource requirements for implementation of the pathway were determined and clinician compliance with the care pathway was assessed to evaluate the feasibility of the pathway in supporting delivery of evidence-based care.

Results

The evidence-based care pathway was implemented in 2011 with the final care pathway based on recommendations from five international evidence-based guidelines. Overall clinician compliance with delivering nutrition management described in the care pathway was high at 84%. The dietetic resource requirement for implementation of the care pathway was 300 to 400 h per 100 patients depending on conditioning chemotherapy regimen.

Conclusion

A robust process for developing and implementing a nutrition care pathway for HSCT patients was effective in supporting the delivery of evidence-based nutritional management for patients treated with HSCT.

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Acknowledgements

The authors would like to thank the multidisciplinary haematology team for their support with the development and implementation of the care pathway. No funding was received to complete this work.

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Authors and Affiliations

  1. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, 305 Grattan St, Parkville, Victoria, 3000, Australia

    Lauren Atkins, Belinda Steer, Hannah Ray & Nicole Kiss

  2. Faculty of Medicine, Dentistry and Health Sciences, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia

    Nicole Kiss

  3. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria, 3000, Australia

    Nicole Kiss

  4. Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia

    Nicole Kiss

Authors
  1. Lauren Atkins
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  2. Belinda Steer
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  3. Hannah Ray
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  4. Nicole Kiss
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Contributions

All authors have made substantial contributions to the design of the study, collection or interpretation of data and writing the manuscript.

Corresponding author

Correspondence to Lauren Atkins.

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Atkins, L., Steer, B., Ray, H. et al. Implementing and sustaining an evidence-based nutrition service in a haematology unit for autologous stem cell transplant patients. Support Care Cancer 27, 951–958 (2019). https://doi.org/10.1007/s00520-018-4384-x

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  • DOI: https://doi.org/10.1007/s00520-018-4384-x

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