Standardized nutritional screening and assessment for nasopharyngeal cancer patients: an evidence-based...

Radiotherapy for nasopharyngeal cancer (NPC) frequently induces malnutrition, which is a serious complication that adversely affects patients' quality of life and prognosis. Although there are currently nutritional assessment procedures for such patients, their clinical effectiveness requires further investigation.

This study aims to evaluate the impact of implementing an optimal nutritional assessment strategy on the nutritional management skills of nurses and patients and on the nutritional status of NPC patients undergoing radiotherapy.

The project followed a three-phase approach. In the first phase, a systematic search and critical appraisal of evidence on nutritional management for NPC radiotherapy patients was conducted, yielding 17 best-practice items and 18 audit indicators. A baseline assessment of these indicators was subsequently performed in a radiotherapy ward between November 2024 and January 2025. The findings from this audit informed the second phase, where barriers and facilitators were analyzed using the Consolidated Framework for Implementation Research. This analysis led to the development of the 4 C Nutrition pathway as the core intervention strategy, which was implemented in the third phase from March to May 2025. The effectiveness was evaluated by comparing pre- and post-implementation data on audit compliance, knowledge levels of nurses, patients' treatment adherence, and nutritional status indicators. Comparative analyses used paired or independent-sample t-tests for continuous variables and chi-square tests for categorical variables, with significance set at P < 0.05 (SPSS software, version 25.0).

A total of 51 patients were included pre-implementation, compared to 52 post-implementation. Following evidence translation, the implementation rates of nurse review indicator increased overall from a range of 0% to 90.2% pre-implementation to 50.00% to 100.00% post-implementation. Nurse nutrition management knowledge questionnaire scores increased from (68.22 ± 5.90) to (85.11 ± 7.10). Patients' nutritional management adherence scores increased from (103.43 ± 12.92) to (117.00 ± 5.97). Moreover, at the 4-week follow-up, the hemoglobin level in the post-implementation group (126.38 ± 6.19) g/L was significantly higher than the pre-implementation level (109.58 ± 17.15) g/L. All these differences were statistically significant (P < 0.05).

The implementation effectively enhanced the standardization of clinical nutritional assessment for nurses, significantly narrowed the gap between clinical practice and best evidence, and improved the knowledge of nutritional management among nurses and patients.

This study has been retrospectively registered with the China Clinical Trial Registry.

ChiCTR2500107011. Registration date: 1 August 2025.