References
Improving the experience of patients who receive home enteral tube feeding
Abstract
Home enteral tube feeding is an increasingly common intervention for patients who are unable to meet their full nutritional requirements. These patients require specialist support to enable them to live as normal a life as possible at home. An integrated acute and community nutrition service developed a new role of community nutrition nurse (CNN) in 2016, with the goal of reducing the number of unplanned hospital attendances relating to enteral tube feeding issues. Following the introduction of the CNN and related troubleshooting interventions, there was a 93% reduction in unplanned hospital admissions between 2017 and 2018. The role has been found to have many benefits, such as improved patient experience, care closer to the patient's home and empowerment of patients, their relatives and carers. It has also helped to increased patient and carer confidence to self-care and has reduced costs within the acute hospital system relating to unplanned hospital attendances and admissions.
The prevalence of home enteral tube feeding (HETF) is increasing (Ojo, 2015; Ford, 2019). There are various reasons why patients may require artificial tube feeding, including undergoing treatment for head and neck cancer, dysphagia relating to a cardiovascular accident or trauma and prophylactic placement for those who have a degenerative condition, such as motor neurone disease. The British Artificial Nutrition Survey (BANS) report (2018) reported that head and neck cancer was the most common reason that patients needed artificial feeding tube placements. Artificial feeding tube placement is a surgical procedure requiring significant ongoing care, maintenance and monitoring. White (2000) and Ford (2019) highlighted how patients and relatives require support around the practicalities of the feeding tube. There are common complications relating to the care of the gastrostomy site and the feeding tube, such as site infections, tube displacement and buried bumper syndrome. Patients require specialist assessment and monitoring from both a dietetic and nursing perspective.
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