MEDIA INFORMATION from
BAPEN the British Association for Parenteral and Enteral Nutrition
Registered Charity No.1023927
Issued Tuesday, 19 November 2003
Nutrition Support Teams dramatically improve patient care
New study presented at the BAPEN symposium demonstrates up to eight out of ten artificial feeding referrals may be inappropriate
Telford, 19 November 2003 - Screening by a multidisciplinary Nutritional Support Team (NST) dramatically reduces the number of patients requiring artificial feeding by up to 80%, according to two new studies presented at the Annual Meeting of BAPEN.
The first study indicates that by implementing screening in nursing homes, referrals for enteral feeding (usually via a nasogastric tube) can be reduced by a massive 80%. These dramatic results were achieved by emphasising oral feeding and consultation with the patient's own GP, together with training of nursing home staff in the ethical aspects of feeding.
Heather Wanstall, Chief Dietitian and co-author of the study, said, "We wanted to establish where tube feeding was in the patient's best interests. In some cases it was recognised that tube feeding was not appropriate, so the introduction of a decision-making pathway has helped to ensure that all options are considered for each individual."
In the second study, undertaken within a hospital, screening resulted in a 65% decrease in those undergoing gastrostomy, where a feeding tube is inserted through a surgical incision in the stomach. Prior to the introduction of screening, 100% of patients referred underwent the procedure. The introduction of a referral pro-forma, a pre-assessment checklist and counselling and discussion with the patient and their carer led to only 35% of referrals resulting in tube placement.
Paula Edwards, Clinical Nurse Specialist Nutritional Support, co-author of the study, commented, "Issues surrounding gastrostomy and aftercare have many clinical, moral and ethical dilemmas. Mortality and morbidity are not the only measure of the value of interventions; quality of life issues need careful consideration. We have found that multidisciplinary NST working, including carers and patients where possible, provides a safe, high quality, equitable service for patients in both the primary and secondary health care setting."
Dr. Alastair Forbes, Chairman of BAPEN and Consultant Gastroenterologist at St Mark's Hospital said, "This study demonstrates the importance of screening prior to artificial feeding. The impact on quality of life means that we must be sure that only patients who need the procedure are given it."
Contact details
For further information please contact:
Jacqui Dyson - Tel: 07713 406290 - Email: jdyson@gciuk.com
Ian McDermott - Tel: 020 7072 4344 - Email: imcdermott@gciuk.com
Notes to Editors
A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope (a flexible, lighted instrument) to determine where to place the feeding tube in the stomach and secure it in place. The surgical procedure and tubes are also referred to as PEG (percutaneous endoscopic gastrostomy).
BAPEN is the British Association for Parenteral and Enteral Nutrition, a charity dedicated to advancing clinical nutrition. Their Annual Meeting is held at the Telford International Centre, November 19-20, 2003.
This release is based on two abstracts:
1. 'Impact of a Nutritional Support Team on the gastrostomy services within a District General Hospital and Community Trust' by P. Edwards, J. Wykes, C. Edmondson, J. Power and S. Monk, Nutritional Support Team, North East Wales NHS Trust, Croesnewydd Road, Wrexham, LL13 7TD.
2. 'Appropriate home enteral feeding in a nursing home - implementing a decision-making pathway to improve patient selection' by M.J. Gall, and H.J. Wanstall, Department of Nutrition and Dietetics, Darent Valley Hospital, Dartford, Kent DA2 8DA.