Learning Objective #1: Articulate the current research of early post operative feeding and its connection with positive patient outcomes

Learning Objective #2: Experience the challenges and successes of applied nursing research through shared dialogue and experiences of the grassroot research process

---

This quantitative study compares traditional post-operative diet advancement to an early feeding protocol. Time to food tolerance is the dependent variable. The accelerated feeding protocol is framed within a patient driven model and includes active patient participation during recovery. The patient's self- report of hunger is incorporated into the criteria for safe diet progression. Study significance is based on the understanding that nutrient tolerance and return of gastrointestinal function drive the patient's comfort, recovery, and subsequent discharge. Current research suggests that early diet advancement results in positive patient outcomes and financial benefits for health care organizations. Study procedure includes random patient assignment based on criteria set for the population with a physician approved pre-printed order as the intervention. A standardized order provides safe diet advancement for the experimental group and includes, a patient self-report hunger scale to quantify hunger, advancement criteria, and symptom assessment and interventions. Multiple variables may affect hunger and food tolerance in the postoperative patient. Data on demographics, analgesics use, mental status, pain, nausea, hunger, activity and presence of social support during hospitalization is measured. Data collection is done by informed RNs assigned to the patient. Data collection occurs at point of care. This structure provides an opportunity to incorporate applied research techniques to the study process and the contextual patient- nurse relationship provides a forum for this to take place. Prior research has focused on the ability of surgical patients to tolerate early postoperative feeding with evidence that outcomes are positive. There are virtually no studies that have combined an early feeding protocol with a patient driven model that incorporates standing diet advancement orders and the patients' reports of hunger and satiety. Significant questions can be raised regarding potential benefits of a patient driven diet advancement model both from an individual and organizational perspective.