Development and evaluation of a home enteral nutrition team

Nutrients. 2015 Mar 5;7(3):1607-17. doi: 10.3390/nu7031607.

Abstract

The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Caregivers
  • Cost Savings
  • Cost-Benefit Analysis*
  • Enteral Nutrition* / economics
  • Enteral Nutrition* / methods
  • Gastrostomy
  • Health Services / economics
  • Health Services / standards*
  • Home Care Services / economics
  • Home Care Services / standards*
  • Hospitalization
  • Humans
  • Middle Aged
  • Nutritional Status
  • Outcome Assessment, Health Care
  • Patient Care Team / economics
  • Patient Care Team / standards*
  • United Kingdom
  • Young Adult