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Malnutrition, enteral nutrition and the use of the percutaneous endoscopic gastrostomy
Eckersley, Deborah
Eckersley, Deborah
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2014
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dissertation
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Abstract
The number of adult patients in the community receiving enteral feeding
via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in
relation to PEG were highlighted by a community multidisciplinary team including
delayed referrals and discharges. The study aimed to explore retrospectively outcomes
in relation to PEG insertion following the implementation of a pilot community PEG
placement care pathway. The number of adult patients in the community receiving enteral feeding
via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in
relation to PEG were highlighted by a community multidisciplinary team including
delayed referrals and discharges. The study aimed to explore retrospectively outcomes
in relation to PEG insertion following the implementation of a pilot community PEG
placement care pathway.The number of adult patients in the community receiving enteral feeding
via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in
relation to PEG were highlighted by a community multidisciplinary team including
delayed referrals and discharges. The study aimed to explore retrospectively outcomes
in relation to PEG insertion following the implementation of a pilot community PEG
placement care pathway. Data were analysed for a sample of participants over 18 years of age in
three communities, served by a district general hospital in the North West of England.
Group 1; ten participants managed on the community PEG placement care pathway
and Group 2; ten participants who were not managed on community PEG placement
care pathway with a similar primary diagnosis to Group 1. PEG insertion required to
maintain nutritional status, hydration and/or medication administration for greater
than fourteen days. Group 1 data for referral to treatment (RTT) waiting time was
compared with the National Health Service (NHS) RTT waiting times for
gastroenterology. Group 1 data for length of stay (LOS) following PEG insertion was
compared to Group 2 data by conducting an Independent t‐test to analyse LOS
between the two groups. A measure of central tendency obtained for LOS for Group 1
and Group 2 data was used in the calculation to estimate treatment cost. Group 1 data
to estimate treatment cost was compared to Group 2 data by conducting an
Independent t‐test to analyse treatment cost between the two groups. Data collection was obtained to establish if the hospital’s PEG information booklet was provided prior to PEG insertion. 6/10 participants in Group 1 had a RTT waiting time of 1 to 58 days. Median
LOS for Group 1 was 4 days; Median LOS for Group 2 was 10 days. Group 1 had an
estimated treatment cost of £1114.15 per patient; Group 2 had an estimated
treatment cost of £2314.15 per patient. 7/10 Group 1 participants were provided with
the hospital’s PEG information booklet at least one week prior to PEG insertion. A reduction in LOS, a RTT waiting time within 18 weeks and a lower
estimated mean treatment cost were noted for Group 1 participants. Expansion of the
exploratory study is required so the objectives generated can be challenged further.
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University of Chester
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Type
Thesis or dissertation
Language
en