Subject(s)
Extracorporeal Membrane Oxygenation , Pancreas Transplantation , Adult , Brain Death , Female , Graft Survival , Humans , Lipase/blood , Male , Middle Aged , Young AdultABSTRACT
In the Cambridge health district the growth of artificial nutritional support was prospectively assessed over a five-year period (1988-93). The aim of this study was to investigate the variation in the prevalence of enteral tube feeding (ETF) and parenteral nutrition (PN) in hospital and at home and to assess the organisation. There was a fourfold variability in the prevalence of artificial nutritional support in the eight districts. The prevalence of home artificial nutrition doubled between 1988 and 1993, whilst that in hospital increased to a smaller extent (31%). Overall standards of care are not keeping pace with the demand for artificial nutritional support. Only half the districts had nutrition teams, and only one had a specialist nutrition sister. Policies about ETF and PN in hospital and at home were judged to be variable in quality. About one in five patients (or carers) at home experienced problems related to organisation of nutrition support services. General practitioners were also frequently uncertain about their role in managing patients on artificial nutrition at home. Home ETF is a rapidly growing form of home care therapy in East Anglia; in 1992-93 it was quantitatively as important as ETF in hospital. Improvements in organisation are recommended.
Subject(s)
Enteral Nutrition , Nutrition Disorders/rehabilitation , Parenteral Nutrition, Home Total , Parenteral Nutrition , Family Practice , Hospitalization , Hospitals, Community , Humans , Infant, Newborn , Nutrition Disorders/etiology , Prevalence , Prospective Studies , Surveys and Questionnaires , United KingdomABSTRACT
Catheter occlusion can complicate parenteral feeding. Careful management can reduce the incidence of occlusion. Low-dose heparin lock is an effective preventive measure.
Subject(s)
Catheters, Indwelling , Heparin/administration & dosage , Parenteral Nutrition, Total/instrumentation , Parenteral Nutrition, Total/nursing , Practice Patterns, Physicians' , Adult , Catheters, Indwelling/adverse effects , Catheters, Indwelling/economics , Child , Equipment Failure , Humans , Injections, Intravenous , Nursing Evaluation Research , Surveys and QuestionnairesABSTRACT
This paper describes the results of a one-year prospective survey of patients who received artificial enteral and parenteral nutritional support at home and in the hospitals of the Cambridge Health District. Enteral tube feeding accounted for most of the artificial nutritional support provided both in hospital and in the community. The findings of the study suggest that nutritional support is an important adjunct to the treatment of serious clinical disorders, and that the care of such patients can be improved by the establishment of a multidisciplinary enteral and parenteral nutrition team. Suggestions are made for establishing a structured home nutritional service.
