The challenges of innovation in the organization of home enteral tube feeding

Howard, Pat; Bowen, N.

doi:10.1046/j.1365-277x.2001.00270.x

Cited by 22 publications

(32 citation statements)

References 16 publications

(22 reference statements)

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“…Larger caseloads will allow dietitians to gain experience, along with formal continuing education (Howard & Bowen, 2001). If dietitians are willing to develop new roles and expand their skills, many more opportunities will be available.…”

Section: Resultsmentioning

confidence: 99%

“…This growth in tube feeding in primary care can be attributed to scientific advances in technology, development of the percutaneous endoscopic gastrostomy technique and the increasing pressure to transfer the care of stable patients from the costly acute hospital setting into primary care (Howard & Bowen, 2001). In the UK there has been a 20 % increase year-on-year in patients registered to be receiving home enteral-tube feeding (HETF), and patients remain on this form of feeding longer (Elia, 1999).…”

Section: Home Enteral-tube Feedingmentioning

confidence: 99%

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

Madigan

2003

Proc. Nutr. Soc.

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Home Enteral-tube Feedingmentioning

confidence: 99%

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

Madigan

2003

Proc. Nutr. Soc.

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“…Similar dietetic-led services have been developed in other areas, for example, Avon and London. In Avon, service changes have been facilitated by changes in financial arrangements within the area [20], which again have facilitated staff to manage the patients and provide the necessary equipment for the process.…”

Section: Discussionmentioning

confidence: 99%

“…Larger caseloads will allow practitioners to gain experience along with formal continuing education and professional development [20]. …”

Section: Discussionmentioning

confidence: 99%

General Practitioners involvement in enteral tube feeding at home: a qualitative study

et al. 2007

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BackgroundComplex medical treatment is moving from hospital to primary care and General Practitioners (GPs) are increasingly asked to undertake new roles. There are now an estimated 19,500 patients being fed in the UK in the community on enteral tube feeding using a variety of different feeding tubes (Percutaneous endoscopic gastrostomy (PEG), Jejunostomy, or nasogastric (NG). The majority of patients are over the age of 65 years when they had artificial feeding initiated and mainly because of dysphagia. The aim of this study was to explore GPs knowledge, attitudes and skills relating to enteral feeding in the community.MethodsSemi-structured one-to-one interviews with a convenience sample of GPs in Northern Ireland.ResultsTwenty-three GPs in three health boards in Northern Ireland participated in the study. Most found dealing with enteral feeding to be a predominantly negative experience. They had little involvement in patient selection for the procedure and poor or no discharge information. GPs felt inadequately trained, there was poor communication between primary and secondary care and little support. There was anger and frustration among GPs about lack of resources (funding and training), and the perception that primary care was used as a dumping ground.ConclusionMoving complex medical treatment from secondary to primary care has major implications for GPs who should be included in the patient selection process, have adequate discharge information about their patients, be adequately resourced and have appropriate support and training.

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“…With respect to nutrition support services that are based in the community, traditionally, these include a General practitioner (GP), the community nurse and sometimes a dietitian [16]. However, the number of patients on Home Enteral Tube Feeding (HETF) in the UK is on the increase partly due to better diagnosis of medical conditions, improved technology and increased longevity in patients with long term conditions [5].…”

Section: Present State Of Enteral Feeding In the Communitymentioning

confidence: 99%

The Impact of Changes in Health and Social Care on Enteral Feeding in the Community

Ojo

2012

Nutrients

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This paper examines the impact of the changes to health and social care on enteral feeding in the community, outlines implications for practice and offers recommendations to ameliorate the challenges. It is now clear that there have been significant changes especially in the last 10 years in health and social care provisions in the UK with an overarching effect on enteral nutrition in the community. Advances in technology, increasing demand and treatment costs, the need for improvement in quality, economic challenges, market forces, political influences and more choices for patients are some of the factors driving the change. Government’s vision of a modern system of health and social care is based on initiatives such as clinically led commissioning, establishment of Monitor, shifting care from acute hospitals to community settings, integrating health and social care provisions, Quality, Innovation, Productivity and Prevention (QIPP) program and the concept of “Big Society”. These strategies which are encapsulated in various guidelines, policies and legislation, including the health and social care Act, 2012 are clarified. The future challenges and opportunities brought on by these changes for healthcare professionals and patients who access enteral nutrition in the community are discussed and recommendations to improve practice are outlined.

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The challenges of innovation in the organization of home enteral tube feeding

Cited by 22 publications

References 16 publications

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

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

General Practitioners involvement in enteral tube feeding at home: a qualitative study

The Impact of Changes in Health and Social Care on Enteral Feeding in the Community

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