Table of Contents
Significance of the Problem
Throughout the career of a nurse, there are an overwhelming number of practices that they must incorporate into their professional routines to better the lives of their patients. Although nurses continually strive for best practice, current research has shown that some interventions may be more detrimental than beneficial. In particular, recent studies have been tackling the dispute of whether a neutropenic diet is something that should continue to be enforced in the cancer population or is it rather something that patients are not benefiting from.
The Journal of Hospital Medicine’s report, Things We Do For No Reason: Neutropenic Diet (2018), drew attention to the common practice of restricting a diet to eliminate the risk of infection in patients receiving chemotherapy. Their study reported that following a neutropenic diet or a low-bacteria diet can rather cause more harm than good for patients.
Maintaining adequate nourishment in cancer patients undergoing chemotherapy can be very challenging. Patients are being deprived of vital nutrients by eliminating substantial foods such as fresh fruits and vegetables, eggs, raw meat, raw fish and soft cheeses. Malnutrition and poor quality of life become major issues for this specific population when a diet such as this is prescribed (Wolfe, Sadeghl, Agrawal, Johnson, & Gupta, 2018).
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Background for the Problem
Neutropenic patients with an absolute neutrophil count of less than 500/mm place them at a significant risk of infection, as their immune systems are greatly compromised due to chemotherapy (Wolfe et al., 2018). Hematopoietic stem-cell transplant (HSCT) recipients are one of the highest at risk patients of contracting infections. According to Wolfe et al., 2018, a total of 726 HSCT patients participated in either a neutropenic diet (363 patients), or a regular diet (363 patients) to abide by.
There were substantially fewer infections reported of the patients consuming a regular diet with no restrictions compared to those adhering to a strict low-bacteria diet (Wolfe et al., 2018). However, the nutrients that make up many of the recommended restricted foods in the neutropenic diet can pivot the viewpoint of its common benefit. Wolfe et al., 2018 states that, “The inefficacy of the neutropenic diet may be attributed to the fact that many of the organisms found on fresh fruits and vegetables are part of the normal flora in the gastrointestinal tract” (2018). This study has helped identify complications for patients of the cancer population following an authoritarian diet plan.
Problem Statement
Avoidable dietary constraints are placing patients at risk in a multitude of categories; one noteworthy is the risk of inadequate intake and malnutrition. Neutropenic diets have more detrimental effects to one’s body as they restrict the adequate nutrition that patients require while receiving chemotherapy. Chemotherapy depletes one’s body tremendously and which may lead to anorexia, stomatitis, and various gastrointestinal disturbances (Sonbol, Firwana, Diab, Zarzour, & Witzig, 2015). Strict diets are enabling this problem even further.
Implications for Nursing
Nurses assist patients to carry out orders and implement them in their lives. The usefulness of a neutropenic diet has never been significantly proven and teaching patients to follow a low microbial diet can be doing more damage than they are already undoing from chemotherapy. Infection, nausea, vomiting, appetite changes, constipation, and diarrhea are a few of the various side effects of chemotherapy (Cancer.org, 2018). All of these side effects alter the lining of the GI tract and the general nutrition of cancer patients.
Nurses can use their knowledge to help alleviate these symptoms. Nurses can educate patients about eating fresh fruits, vegetables, raw meat and fish that can help restore a healthy nutrition but to use caution. Nurses can teach patients to adequately wash and clean all fruits and vegetables, separate raw meats, cook to the right temperatures, and refrigerate food appropriately.
According to Wolfe et al., 2018, restricting cancer patients from foods that contain the natural floras that could improve chemotherapy side effects should not be incorporated into nursing practice; nurses should rather help replete their bodies with all that’s been exhausted.
