Early Nutrition Support in Neurosurgical Patients as guided by I-FEED scores

The authors have collaborated with the primary institution in order to incorporate the I-FEED score into the standardized care pathway of spinal neurosurgical patients. The I-FEED score is a decision making tool designed by the American Society for Enhanced Recovery and Perioperative Quality Initiative to facilitate assessment and guidance of postoperative feeding. This quality improvement initiative has been considered and will be implemented at an agreed timeframe between the authors and primary institution. This change will occur in January 2020. All appropriate stake holders have been educated in the implementation and clinical decision making as pertaining to the I-FEED scoring system. Following an agreed protocol change in post-operative nutrition management, the second cohort of patients will be observed. The second cohort will receive the newly implemented standard of care using the I-FEED score as a measure of post-operative gastro-intestinal function. I-FEED score will therefore guide the post-operative fasting period and time to oral nutrition. All usual peri-operative high standard care will be delivered as per surgeons and anaesthetists preferences in both cohorts of patients.I-FEED score is an international score designed to assess the postoperative gastrointestinal function.It is a decision making tool designed to guide the initiation of postoperative nutrition. Patients will receive a maximum 2 points for the categories of nausea, pain, intake, examination and duration of symptoms.