Prospective Assessment of Peristomal Infections Using Objective Criteria

Mundi, Manpreet S.; Seegmiller, Sara L; Davidson, Jacob B.; Schneckloth, Jill; Saied, Jessica; Hurt, Ryan T.

doi:10.1002/jpen.1020

Cited by 9 publications

(31 citation statements)

References 25 publications

(48 reference statements)

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“…Peristomal infections are another common complication associated with percutaneous tubes with reported rates as high as 5%–30% with high risk patients being those with type 2 diabetes, advanced malignancy, colonization with methicillin-resistant Staphylococcus aureus , or severe malnutrition [ 29 ]. The prevalence rates continue to be variable due to lack of objective criteria for diagnosis.…”

Section: Practical Considerations In Home Enteral Nutritionmentioning

confidence: 99%

Home Enteral Nutrition: Towards a Standard of Care

et al. 2018

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The purpose of this overview is to make the case for the establishment and publication of standards for home enteral nutrition (HEN) therapy in adult patients who require a long-term alternative to oral feeding. Overviews can provide a broad and often comprehensive summation of a topic area and, as such, have value for those coming to a subject for the first time. It will provide a broad summation, background and rationale, review specific considerations unique to HEN (tubes, products and supplies) and we describe a recent audit of seven HEN programs which highlights tube and process related challenges. Based on the overview of the literature and our experience with the audit we propose a way forward for best home enteral nutrition care.

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Section: Practical Considerations In Home Enteral Nutritionmentioning

confidence: 99%

Home Enteral Nutrition: Towards a Standard of Care

et al. 2018

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“…Additionally, when patients report a symptom, an image can be sent by patient through EMR to provide additional information. Previously, our group had developed an objective criterion to risk‐stratify peristomal infections based on degree of erythema, induration, and discharge 35 . This criteria can be adapted for use in telehealth and may be expanded to other complications, such as central line insertion site infections.…”

Section: Type Of Visitmentioning

confidence: 99%

“…Previously, our group had developed an objective criterion to risk-stratify peristomal infections based on degree of erythema, induration, and discharge. 35 This criteria can be adapted for use in telehealth and may be expanded to other complications, such as central line insertion site infections. In addition to images, when patients report symptoms that require further evaluation by a provider, a short telehealth visit can be scheduled to obtain additional information and develop plan for appropriate workup.…”

Section: Type Of Visitmentioning

confidence: 99%

Use of telehealth in home nutrition support: Challenges and advantages

et al. 2021

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Coronavirus disease 2019 (COVID‐19), after initially being detected in Wuhan, China in late 2019, quickly spread to most regions of the world, meeting World Health Organization criteria for a pandemic. Social distancing along with other measures implemented to control spread had a drastic impact on the provision of healthcare including deferred elective procedures and surgeries as well as delayed care and evaluation for emergent diagnoses such as heart attacks and strokes. In the home nutrition practice, patients began to delay routine laboratory tests and were canceling or deferring annual visits. Our group soon began to rapidly deploy telehealth to meet the needs of the home nutrition patients. Telehealth is not a new concept with descriptions of healthcare being provided at a distance with the use of telephone in the 1870s. However, widespread adoption has been limited because of regulation (licensure, prescriptions, credentialing, and privileges), lack of reimbursement, as well as adoption and availability of technology needed to carry out telehealth visits. As regulations and limits on reimbursements were waived during COVID‐19 pandemic, our home nutrition practice began to evaluate core components of the care we provide for our patients and assess which could be successfully transitioned to telehealth. In addition to the history and regulation of telehealth, the current manuscript provides details regarding successful implementation of telehealth visits such as change management, selection of telehealth platform, scheduling and logistics, as well as carrying out the virtual visit including history and physical exam.

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“…Diagnosing bacterial infection at the stoma site is more difficult because bacteria are always present on the skin surface, often leading to overtreatment (Figure ). An infection assessment tool using objective criteria (induration, erythema, and discharge) has been developed to identify and more appropriately triage bacterial infection of stoma sites, reducing unnecessary antibiotic treatment . Leaking at the stoma site and increased friction may cause the formation of granulation tissue (Figure ).…”

Section: Mechanical and Infectious Issuesmentioning

confidence: 99%

“…An infection assessment tool using objective criteria (induration, erythema, and discharge) has been developed to identify and more appropriately triage bacterial infection of stoma sites, reducing unnecessary antibiotic treatment. 25 Leaking at the stoma site and increased friction may cause the formation of granulation tissue ( Figure 2). If not properly treated, granulation tissue can lead to serious infection, so keeping the stoma site dry and avoiding friction to the site must be emphasized to caregivers.…”

Section: Infectionmentioning

confidence: 99%

Addressing Frequent Issues of Home Enteral Nutrition Patients

et al. 2019

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The home enteral nutrition (HEN) population is a medically diverse group whose number has increased substantially in recent decades. Although medically stable compared with acute care patients requiring nutrition support, HEN population needs are unique and require a team approach to manage nutrition. Frequently encountered issues by the HEN team include mechanical issues of the tube site, gastrointestinal and metabolic problems, and patient preferences regarding tube weaning, formula selection, and compliance. A thorough search of the published literature on how to manage these issues was conducted using scientific healthcare databases with the following inclusion criteria: English only, last 10 years, and reviews and clinical trials. Where appropriate, references from the retrieved articles were hand‐searched for relevant articles older than 10 years and cited in this review. The purpose of this review is to provide the HEN team with strategies to address the top issues of home enteral feeding.

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Prospective Assessment of Peristomal Infections Using Objective Criteria

Cited by 9 publications

References 25 publications

Home Enteral Nutrition: Towards a Standard of Care

Home Enteral Nutrition: Towards a Standard of Care

Use of telehealth in home nutrition support: Challenges and advantages

Addressing Frequent Issues of Home Enteral Nutrition Patients

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