scholarly journals Home enteral-tube feeding: The changing role of the dietitian

2003 ◽  
Vol 62 (3) ◽  
pp. 761-763 ◽  
Author(s):  
Sharon M. Madigan

Enteral feeding in primary care has increased markedly over the last decade. It allows patients to be discharged to home or residential care who previously would have remained in hospital. Difficulties do arise for patients, their carers and health professionals, as care of these patients and support for health professionals is often patchy or non-existent. Dietitians are uniquely placed to participate in the management of tube feeding in primary care, provide support and education to patients and their carers, evaluate treatment and promote better outcomes for patients receiving tube feeding.

2021 ◽  
Vol 19 (10) ◽  
pp. 26-34
Author(s):  
Mehri Doosti-Irani ◽  
Farangis Heidari Goojani ◽  
Leila Rafiee Vardanjani ◽  
Kobra Noorian

Aim: This study aimed to explore family caregivers' experiences with tube feeding at home in Iran. Methods: This qualitative study was conducted with purposefully selected family caregivers who participated in an in-depth, semi-structured, face-to-face interview. Data analysis was performed through content analysis and rigor was investigated. Results: In total, 20 caregivers were interviewed. Two main categories were found in the interview data: ‘abandoned training’ and ‘lack of knowledge of nutrition’. Participants felt abandoned and unsupported by health professionals. Participants also reported feeling that health professionals passed the training responsibility to other health professionals who did not give training. This resulted in participants feeling obligated to learn from their peers. Participants lacked knowledge about nutrition, as well as how to prepare home-made formula for feeding, the correct position for feeding and feeding times. Conclusion: Despite having a heavy and vital responsibility, participants felt that they had not been adequately trained and thus faced making errors, resulting in negative consequences for the patient and the family. Therefore, appropriate plans must be made to promote preparation for home care.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1046 ◽  
Author(s):  
Omorogieva Ojo ◽  
Edel Keaveney ◽  
Xiao-Hua Wang ◽  
Ping Feng

Patients with functional gastrointestinal tract who are unable to meet their nutritional requirements may benefit from the use of enteral nutrition via feeding tubes which could be nasogastric, percutaneous endoscopic gastrostomy and jejunostomy. Although enteral tube feeding has been shown to promote nutritional status, improve wound healing, and enhance patients’ quality of life (QoL), evidence of tube and feed complications and reduced QoL has also been reported. Despite the increasing prevalence of patients on enteral tube feeding, no systematic review examining the role of enteral tube feeding on patients’ QoL appears to have been published. Aim: The aim of this systematic review is to evaluate the effect of enteral tube feeding on patients’ QoL. Method: Three databases (EMBASE, Pubmed, and PsycINFO) plus Google Scholar were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and involved the use of synonyms and medical subject headings. In addition, search terms were combined using Boolean operators (AND/OR) and all the articles retrieved were exported to EndNote for de-duplication. Results: Fourteen articles which met the criteria were included and three distinct areas were identified: the effect of early versus late enteral tube feeding on QoL; the QoL of patients on gastrostomy versus standard care, and the effect of enteral tube feeding on QoL. Overall, nine studies reported improvement in the QoL of patients on enteral tube feeding, while five studies demonstrated either no significant difference or reduction in QoL. Some factors which may have influenced these outcomes are differences in types of gastrostomy tubes, enteral feeding methods (including time patients spent connected to enteral feed/pump), and patients’ medical conditions, as well as the generic and/or type of QoL measuring instrument used. Conclusion: Most reviewed studies suggest that enteral tube feeding is effective in improving patients’ QoL. The use of enteral tube feeding-specific QoL measuring instruments is recommended for future research, and improved management strategies including use of mobile enteral feeding pumps should further enhance patients’ QoL. More studies on the effect of delivery systems/enteral feeding pumps on QoL are needed as research in this area is limited.


2011 ◽  
Vol 28 (6) ◽  
pp. 647-654 ◽  
Author(s):  
E. K Watson ◽  
R. O'Brien ◽  
C. Campbell ◽  
D. Weller ◽  
R. D Neal ◽  
...  

2019 ◽  
pp. 457-464
Author(s):  
Gerri Mattson ◽  
Karen Remley

This chapter is about the changing role of the primary carer in the health setting with a particular focus on the training of primary carers. Primary care providers are already increasingly called on to expand their practice beyond their traditional knowledge and skills in clinical medicine. The chapter looks at the population health competency of primary health carers. Primary care providers, once trained, in the community can serve as mentors for trainees, which can provide additional perspective and experience outside of the academic setting. The chapter goes on to argue that the health and well-being of the entire community are dependent on the collaborative work of health care providers, public health, community organizations, faith-based organizations, and the community itself. Understanding the myriad connections, competencies, and impacts of these partnerships allows clinicians to engage with the community early in their careers; to deepen their engagement, understanding, and ability over time; and to be effective advocates with and on behalf of the communities they serve.


2019 ◽  
Vol 35 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Matko Marlais ◽  
Jelena Stojanovic ◽  
Helen Jones ◽  
Shelley Cleghorn ◽  
Lesley Rees

Abstract Background Enteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age. Methods Retrospective study of pre-transplant, pre-pubertal children (< 11 years) with CKD stages 2–5 started on nasogastric tube or gastrostomy feeds for the first time after age 2 years. Children were identified by searching dietetic records and the renal database. Children on growth hormone were excluded. Height, weight, and BMI were documented 1 year prior to and at the start of tube feeds, and after 1 and 2 years. Data collection ceased at transplantation. Results Fifty children (25 male) were included. The median (range) age at start of tube feeds was 5.6 (2.1–10.9) years. Sixteen children were dialysed (1 haemodialysis, 15 peritoneal dialysis); 34 predialysis patients had a median (range) eGFR of 22 (6–88) ml/min/1.73 m2. Overall height SDS (Ht SDS) improved from − 2.39 to − 2.27 at 1 year and − 2.18 after 2 years (p = 0.02). BMI SDS improved from − 0.72 to 0.23 after 1 year and was 0.09 after 2 years of enteral feeding (p < 0.0001). Height SDS improved more in children aged 2–6 years (− 2.13 to − 1.68, p = 0.03) and in children not on dialysis (− 2.33 to − 1.99, p = 0.002). Conclusions Enteral tube feeding commenced after 2 years of age in prepubertal children with CKD improves height and weight SDS, with stability of BMI during the second year. Younger children and those not on dialysis had the greatest benefit.


2020 ◽  
Vol 25 (4) ◽  
pp. 178-183
Author(s):  
Ruth Carter-Stephens

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.


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