A 3‐month survey of enteral tube feeding and parenteral feeding: a baseline for improvement

Abstract

This paper presents the results of a 3‐month survey of tube feeding and parenteral nutrition in hospital in‐patients, undertaken to provide information for the development of guidelines by the Hospitals Nutritional Advisory Group and a baseline for future monitoring. This represents the first steps in the audit cycle. The results highlighted the following problems. Total parenteral nutrition is often continued after bowel sounds have returned. Enteral tube feeding is often instituted for only a very short period of time and may be of little nutritional benefit to the patient. Significantly lower amounts of energy and nitrogen are received by the patients in the enterally tube‐fed group than is indicated by their estimated energy and nitrogen requirements. The medical staff noted the start of feeding in 60% of the case notes, however, the aims of feeding and the reason for commencing feeding were never documented. Nutritional aims were defined in the case notes by dietitians for all tube‐fed and 18 of the 20 patients who were parenterally fed.

Organizational aspects of starting and running an effective nutritional support service

“…Any new nutrition team should be aware of the seminal literature together with any reports which also question the benefits of a CNST (33,34). It will be helpful to underpin this by reviewing local practice (35)(36)(37)(38) and comparing it with any published data (10,39). This could include audits of clinical practice, e.g.…”