Transitioning Pediatric Patients With Short Bowel Syndrome to Enteral Autonomy: The Role of the Pediatric Surgical Nurse in Coordinating Home-Based Adaptation and Feeding Management

Abstract

Short bowel syndrome in children, most commonly following extensive intestinal resection, results in intestinal failure and prolonged dependence on parenteral nutrition. Achieving enteral autonomy—sustained nutritional independence through enteral feeding—is a primary goal to reduce complications, support growth and development, and improve quality of life. Pediatric surgical nurses play a central role in coordinating seamless hospital-to-home transitions through structured family-centered education, nurse-coordinated home monitoring, and collaborative feeding adjustments. This continuity of care article synthesizes evidence-based strategies from multidisciplinary intestinal rehabilitation guidelines and codifies practical nursing practices that support informational, relational, and management continuity. Emphasis is placed on nurse-facilitated home monitoring protocols for intestinal adaptation, incremental feeding advancement, and early complication recognition. Common barriers, including caregiver burden and resource limitations, are addressed, and the potential role of telehealth in sustaining community-based care is explored. This nurse-coordinated model strengthens holistic pediatric surgical nursing practice across hospital, home, and community settings.

Keywords

short bowel syndrome enteral autonomy intestinal adaptation continuity of care pediatric surgical nursing family-centered care transition to home telehealth

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References

Duggan

C. P.

Jaksic

Koletzko

(2017). Intestinal rehabilitation programs in the management of pediatric intestinal failure and short bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition, 65(5), 588–596. https://doi.org/10.1097/MPG.0000000000001727

Hukkinen

Mutanen

Pakarinen

M. P.

(2023). Predictors of enteral autonomy in pediatric short bowel syndrome: A multicenter experience. Journal of Pediatric Surgery, 58(4), 678–685. https://doi.org/10.1016/j.jpedsurg.2022.11.012

Khan

F. A.

Fisher

J. G.

Sparks

E. A.

Duggan

Modi

B. P.

(2015). Predictors of enteral autonomy in children with intestinal failure: A multicenter cohort study. The Journal of Pediatrics, 167(1), 29–34.e1. https://doi.org/10.1016/j.jpeds.2015.03.040

Miller

A. R.

Condin

C. J.

McKellin

W. H.

Shaw

Klassen

A. F.

Sheps

(2009). Continuity of care for children with complex chronic health conditions: Parents’ perspectives. BMC Health Services Research, 9, 242. https://doi.org/10.1186/1472-6963-9-242

Modi

B. P.

Staffa

S. J.

Duggan

(2022). ASPEN Definitions in pediatric intestinal failure. Journal of Parenteral and Enteral Nutrition, 46(3), 567–578. https://doi.org/10.1002/jpen.2232

Murray

J. M.

(2012). An integrative review of the literature about the transition of pediatric patients with intestinal failure from hospital to home. Journal for Specialists in Pediatric Nursing, 17(4), 277–287. https://doi.org/10.1111/j.1744-6155.2012.00325.x