A Survey of Regional Percutaneous Endoscopic Gastrostomy Discharge Practices

Abstract

Aim: The discharge of a patient with a percutaneous endoscopic gastrostomy (PEG) is often complicated by important practical and logistic but not medical problems. The purpose of this survey study was to collect data about discharge procedures in patients with a PEG in order to improve discharge procedures and evaluate the home-care environment. Methods: Questionnaires were sent to 25 hospitals. Questions were related to the incidence of PEG tube placement, the discharge procedure, and problems experienced relating to the home-care setting. Results: The regional incidence of PEG tube placement was calculated to be 1:1500 inhabitants per year. The most frequent indications for PEG were neurologic and esophageal disease. Generally, coordination of the discharge was carried out by a nonmedically trained discharge manager or dietitian. Tube feeding instructions were given to the patient by the nurse or dietitian and at-home support was provided by the patient/family member or district nurse. The discharge process generally took 3 days. Fifty-three percent (10/19) responded favorably to the suggestion to delegate the task of at-home care for the PEG to a professional service. Complications in the home after discharge were infections, tube leakage, and occlusion. Conclusion: At present, PEG tube placement is an accepted clinical procedure. Discharge from the hospital takes several days. More than 50% of the respondents have a positive attitude to a structured discharge procedure and the institution of a specialized home-care team outside the hospital. A regional survey of PEG discharge practices yielded useful information for future discharge planning.

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References

1. Hussain A , Woolfrey S , Massey J , et al: Percutaneous endoscopic gastrostomy. Postgrad Med J 72:581–585, 1996

2. Pattison D , Young A : Effect of a multi-disciplinary care team on the management of gastrostomy feeding. J Hum Nutr Diet 10:103–109, 1997

3. Hauge T , Aubert E , Sandvei P : Percutaneous endoscopic gastrostomy for enteral nutrition. An evaluation of 50 patients. Tidsskr Nor Laegeforen 118:2:214–215, 1998

4. Norrie MW , Lane MR : Percutaneous endoscopic gastrostomy feeding tubes: A retrospective review at Auckland Hospital 1993-1994. N Z Med J 109:299–301, 1996

5. Vinge OD , Hartvigsen AB , Matzen P : Percutaneous endoscopic gastrostomy. A retrospective study of the course and complications. Ugenskr Laeger 156:3160–3163, 1994

6. Kaw M , Sekas G : Long-term follow-up of consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home patients. Dig Dis Sci 39:738–743, 1994

7. Ireton-Jones C , Orr M , Hennessy K : Clinical pathways in home nutrition support. J Am Diet Assoc 97:1003–1007, 1997

8. Finocchiaro C , Galletti R , Rovera G , et al: Percutaneous endoscopic gastrostomy: A long-term follow-up. Nutrition 13:520–522, 1997