Dietary restrictions for patients with neutropenia: a survey of institutional practices.
OBJECTIVE
To describe institutional practices related to dietary restrictions for patients with neutropenia to determine whether restrictions are used and when they are implemented and discontinued.


METHODS
Descriptive survey.


METHODS
156 institutions belonging to the Association of Community Cancer Centers.


METHODS
Mailed survey.


RESULTS
Of the institutions surveyed, 78% (n = 120) placed patients with neutropenia on restricted diets. Participating institutions responded that patients were placed on restricted diets at a variety of different white blood cell and neutrophil counts, including neutrophils < 1,000 (43%) and < 500 (46%). The majority of institutions (92%) placed patients on restricted diets once neutropenia was documented, while only 9% of institutions restricted diets when cancer treatment was initiated. Of the participating institutions, 83% (n = 96) restricted diets only when patients were neutropenic rather than throughout the duration of the chemotherapy regimen. The most commonly restricted foods were fresh fruits and juices (92%), fresh vegetables (95%), and raw eggs (74%). Few institutions restricted tap water (12%). Wine was restricted at 39% of institutions, and beer was restricted at 40% of institutions.


CONCLUSIONS
The role of diet in the development of infection in patients with neutropenia is unclear. This unclear role contributes to the variation in dietary restrictions among institutions.


CONCLUSIONS
Additional research should focus on dietary factors contributing to neutropenic infections and establishing criteria for implementation of specific dietary modifications. Nursing assessment should include nutritional status and risk factors for neutropenia and bacterial translocation. Nursing protocols for neutropenic dietary restrictions should be based on research findings.
Smith
L H
LH
Grant/Riverside Methodist Hospitals, Columbus, OH, USA. smithagary@aol.com
Besser
S G
SG
D001424:Bacterial Infections / Q000517:prevention & control*; D004032:Diet / Q000592:standards*; D005521:Food Service, Hospital / Q000592:standards; D006801:Humans; D009503:Neutropenia / Q000178:diet therapy* / Q000451:nursing*; D009859:Oncology Nursing; D011795:Surveys and Questionnaires; D014481:United States