6 Enteral nutrition: background, indications and management

Percutaneous Endoscopic Gastrostomy in Neurological Patients

“…Nasogastric tubes have the advantage of being simple to insert but are often poorly tolerated by the patient, and are difficult to maintain in position. They have a significant associated risk of aspiration (Ciocon et al, 1988), and carry a high risk for accidental displacement (Keohane et al, 1986;Payne-James & Silk, 1988). The benefits of placing a nasogastric tube include the fact that little skill is required for tube placement and it enables early commencement of enteral feeding.…”

Frequency of and indications for wholly compensatory nursing care related to enteral food intake: a secondary analysis of the Belgium National Nursing Minimum Data Set

“…Total feeding assistance and tube feeding are examples of wholly compensatory nursing care. Based on this model and extensive review of the literature (McFarland & McFarlane 1997, Bulechek & McCloskey 1992, Henderson 1991, Kayser-Jones 1990, Payne-James 1990, Peck et al 1990, Sandman et al 1990, Eisenberg 1989, Compher et al 1989, Quill 1989 , Watts et al 1989, Wilmore 1989, American Society for Parenteral Nutrition 1988, Breach & Saldanha 1988, Ciocon et al 1988, Maslow 1988, Payne-James & Silk 1988, Backstro È m et al 1997, Feitelson et al 1987, Krey 1986, Siebens et al 1986, Lo & Dornbrand 1984, Rombeau 1984, Weinsien et al 1979, the following theoretical indications were formulated for total feeding assistance and tube feeding (Viane 1993). Total feeding assistance may be indicated when selfcare agency is not developed, which is the case in children younger than 2 years and persons with strong mental retardation.…”

Clinical nutrition support.

“…13 1"Just over one fifth never used radiography to check the position of the tube, though there are certain groups of patients (those with altered consciousness, no gag reflex, or on ventilators) in whom this should be mandatory. 15 Several points of interest were noted for total parenteral nutrition. Although peripheral administration of total parenteral nutrition was used by up to 60% of correspondents, it accounted for only 7% of total parenteral nutrition regimens, and these were predominantly in paediatric units.…”

“…The incidence of this complication has been shown to be significantly reduced when catheter care is monitored by a specialist nurse and in most cases should be avoidable. [8][9][10][11][12][13][14][15][16][17][18][19][20] The findings that only 38% of nutrition teams have specialist nurses and that only 11% of the changes of dressing during central venous catheterisation for administration of total parenteral nutrition were undertaken by such nurses may account for the high incidence of infection reported. The results of the survey and the examples discussed here suggest that patient management may be at odds with the concept of "best documented practice."'"…”