title: Nutrition Interventions to Optimize Pediatric Wound Healing: An Evidence-Based Clinical Pathway.
abstract: Background and Objective: There is no accepted nutrition approach for wound healing in children. Our aims were to determine optimal nutrition support for pediatric wound healing. Methods: We applied local methods to create evidence- and consensus-based recommendations, supported by implementation tools, including algorithms, clinical decision supports, and measures. We applied these recommendations to the care of 49 patients from December 5, 2011, to December 5, 2012. Results: Six articles were found that addressed our clinical questions, and we formulated 5 clinical recommendations. Evidence supported evaluating patients for vitamin C, zinc, and protein deficiency. Of the patients where laboratory values were checked, 9 patients were zinc deficient (33%) and 12 patients were vitamin C deficient (48%). Discussion and Practical Application: The implementation of our recommendations has led to increased identification of micronutrient deficiencies and closer monitoring of nutrition status and intake. Online clinical decision supports can accelerate the adoption of clinical recommendations and reduce provider practice variation.
authors.affiliation: Nutrition Department, Seattle Children's Hospital, Seattle, Washington kirsten.thompson@seattlechildrens.org.
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Thompson
authors.affiliation: Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Leu
authors.affiliation: Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Drummond
authors.affiliation: Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Jean
authors.initials: J
authors.lastname: Popalisky
authors.affiliation: Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Spencer
authors.affiliation: Nutrition Department, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Polly M
authors.initials: PM
authors.lastname: Lenssen
keywords: guidelines; micronutrients; nutrition therapy; nutritional assessment; pediatrics; protein; vitamin C; wound healing; zinc