RESUMO
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.
Assuntos
Análise Custo-Benefício , Nutrição Enteral , Serviços de Saúde/normas , Serviços de Assistência Domiciliar/normas , Equipe de Assistência ao Paciente/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Redução de Custos , Nutrição Enteral/economia , Nutrição Enteral/métodos , Gastrostomia , Serviços de Saúde/economia , Serviços de Assistência Domiciliar/economia , Hospitalização , Humanos , Pessoa de Meia-Idade , Estado Nutricional , Avaliação de Resultados em Cuidados de Saúde , Equipe de Assistência ao Paciente/economia , Reino Unido , Adulto JovemRESUMO
This article discusses how services for people receiving enteral nutrition via a nasogastric or gastrostomy tube at home are organised. The home enteral nutrition team's role is also explored. The National Institute for Health and Care Excellence outlines the need for nutritional support in adults to be high quality and cost effective. It is important therefore that local services are able to provide people receiving enteral nutrition with safe and effective care that they consider satisfactory. The discussion is pertinent to nurses caring for older people because gastrostomy tube placement is increasingly common in people aged over 60. A gastrostomy tube is the usual route by which enteral nutrition is given in the community.
