Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Rachel Pitman

Abstract

Abstract Bariatric surgery is the most clinically efficacious treatment for obesity and obesityrelated comorbidities. Many patients undergoing bariatric surgery have preexisting levels of nutritional deficiencies. The prevalence of micronutrient deficiencies may increase after surgery, and long-term nutritional monitoring and follow-up are essential factors for postoperative patient care; yet advanced practice nurses may not be accustomed to caring for patients or treating micronutrient deficiencies. The purpose of this systematic literature review was to collect and analyze clinical evidence to determine what can the APN with the best available evidence do for implementing protocols and procedures to prevent, detect, and monitor for nutritional deficiencies after surgery in the clinical setting? The data sources were from PubMed, Embase, CINAHL, and Medline. A PRISMA diagram was used to identify 1121 articles including randomized control trials, systematic reviews, and clinical guidelines; of these 17 articles met the criteria. The Johns Hopkins nursing evidence-based model was used as the guiding framework. Analysis of the evidence revealed inconsistent recommendations and guidelines drawn from the leading three bariatric experts as well as limited studies conducted in the United States, United Kingdom, Italy, Germany, India, Brazil, and China for what constitutes deficiencies and supplementation dosages. However, recommendations can be made for a nurse-driven protocol which calls for lifelong routine monitoring based on symptom or type of procedure; daily vitamin and mineral supplementation; and identifying deficiency versus insufficient levels of micronutrients, particularly vitamin B12 and D serum levels. Using the best evidence to guide practice is a start to fostering a positive social change

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