4 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 9
Tips for putting a pre-op nutri-
tion program in place:
• Educate. Eliminating exces-
sive pre-op fasting, and the gen-
eral societal notion of it as a
standard preparation for any
surgery, remains a struggle for
pre-op nutrition. Your challenge
will be educating patients, as
well as the "surrounding and
peripheral doctors patients
might see," says Jennifer
Holder-Murray, MD, FACS, co-
director of University of
Pittsburgh Medical Center's Enhanced Recovery Program (ERP),
an implementation of ERAS principles rolled out in 2015. "They go
back to their PCP, [who] may tell them, 'Remember, don't eat or
drink anything after midnight.' And they forget what the surgeon
told them because they don't want to make a mistake. They'd
rather be safe than sorry."
• Start early. Ideally, a pre-op nutrition program should start 2 to
4 weeks before surgery, but even as little as a week "can make a
huge difference in a patient's nutritional status," says Dr. Holder-
Murray. Prescribe pre-op nutrition not only for nutritionally deplete
patients, but also normally nourished ones, she adds.
• Provide collateral. Send patients home with information
detailing their pre-op nutrition regimen.
DRINK, EAT AND AMBULATE
Putting Pre-op Nutrition into Practice
• STRESS OF SURGERY Pre-surgical supplements in the
immediate pre-operative period help enhance post-op recovery.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
