Strengthening nutrition services for children with cancer.

Abstract

Purpose: As a result of complex and aggressive cancer treatment, the important role of adequate nutrition has been increasingly recognised to optimise both short and long-term outcomes for children however; the international evidence demonstrates inconsistencies in the way children's nutritional needs are addressed. A 'Nutrition service model' has been developed which incorporates an agreed set of protocols, an information suite for families and a process for managing the nutrition needs of children having cancer treatment. The project will also enable the development of a risk adapted model for nutrition support. Method(s): Each child diagnosed with cancer has an initial education and assessment session with a dietician. The session ensures that each family is provided with consistent general information about growth, nutrition and useful tips on managing common feeding problems. Using a screening tool and 'nutrition database' enables the team to assess the child's nutritional status, collect data and use this information for research purposes. Result(s): Structured education and assessments including a screening tool has been completed on all children diagnosed over a 12 month period (n1/4~240). Data will be presented on the number of children within different diagnostic groups and the levels of nutritional care required; the percent of children who present with evidence of malnutrition at diagnosis, the predictability of the screening tool and an audit of the numbers of children with nasogastric tubes or gastrostomy. Conclusion(s): The best practice service model for nutrition services has been designed to provide a consistent and quality service for children with cancer and their families across 'Paediatric Integrated Cancer Service' sites. The 'Nutrition Service Model' has been implemented and evaluated including; implementation of systems to ensure consistent data collation and documentation, a clinical audit of current practices, expansion of information resource suite for families, implementation of a screening tool and the decision-making algorithm for nutritional interventions.