Effect of a multi-disciplinary care team on the management of gastrostomy feeding
Abstract:Background: This study was undertaken to assess current practice in the management of gastrostomy feeding in two district general hospitals and to perform a clinical audit on agreed standards of patient care.
Methods: A retrospective case note review was followed by a prospective audit of agreed guidelines. Twenty-four patients (12 women and 12 men) with tube placement prior to the introduction of standards (group A) and 26 patients (16 women and 10 men) with new gastrostomies placed after the introduction of standards (group B) were included. Five standards were agreed: pre-operative multi-disciplinary assessment, standard percutaneous endoscopic gastrostomy (PEG) tube, pre-operative prophylactic antibiotics, surgical outpatient review and information booklets for patient use. Outcome was measured by the incidence of tube failure, stoma site infection and gastrointestinal (GI) complications.
Results: Twenty-two patients (85%) in group B were assessed pre-operatively by the multi-disciplinary team and the standard tube was placed in 73% of cases. Complications occurred in 92% of patients in group A and in 50% in group B (P<0.05). In light of the findings, a patient care plan has been developed which is now in general use.
Conclusion: Appraisal of current practice in the management of gastrostomy feeding has led to the recognition of complications. These have been reduced by the adoption of guidelines used by the multi-disciplinary team.
Document Type: Original Article
Affiliations: 1: Department of Nutrition and Dietetics, West Herts Community Health NHS Trust, St. Albans, Herts AL3 5PN, UK, 2: Clinical lead in R&D and Audit in Medicine, St. Albans and Hemel Hempstead NHS Trust, St. Albans, Herts AL3 5PN, UK
Publication date: January 1, 1997