Malnutrition, enteral nutrition and the use of the percutaneous endoscopic gastrostomy

Hdl Handle:
http://hdl.handle.net/10034/345816
Title:
Malnutrition, enteral nutrition and the use of the percutaneous endoscopic gastrostomy
Authors:
Eckersley, Deborah
Abstract:
The number of adult patients in the community receiving enteral feeding via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in relation to PEG were highlighted by a community multidisciplinary team including delayed referrals and discharges. The study aimed to explore retrospectively outcomes in relation to PEG insertion following the implementation of a pilot community PEG placement care pathway. The number of adult patients in the community receiving enteral feeding via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in relation to PEG were highlighted by a community multidisciplinary team including delayed referrals and discharges. The study aimed to explore retrospectively outcomes in relation to PEG insertion following the implementation of a pilot community PEG placement care pathway.The number of adult patients in the community receiving enteral feeding via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in relation to PEG were highlighted by a community multidisciplinary team including delayed referrals and discharges. The study aimed to explore retrospectively outcomes in relation to PEG insertion following the implementation of a pilot community PEG placement care pathway. Data were analysed for a sample of participants over 18 years of age in three communities, served by a district general hospital in the North West of England. Group 1; ten participants managed on the community PEG placement care pathway and Group 2; ten participants who were not managed on community PEG placement care pathway with a similar primary diagnosis to Group 1. PEG insertion required to maintain nutritional status, hydration and/or medication administration for greater than fourteen days. Group 1 data for referral to treatment (RTT) waiting time was compared with the National Health Service (NHS) RTT waiting times for gastroenterology. Group 1 data for length of stay (LOS) following PEG insertion was compared to Group 2 data by conducting an Independent t‐test to analyse LOS between the two groups. A measure of central tendency obtained for LOS for Group 1 and Group 2 data was used in the calculation to estimate treatment cost. Group 1 data to estimate treatment cost was compared to Group 2 data by conducting an Independent t‐test to analyse treatment cost between the two groups. Data collection was obtained to establish if the hospital’s PEG information booklet was provided prior to PEG insertion. 6/10 participants in Group 1 had a RTT waiting time of 1 to 58 days. Median LOS for Group 1 was 4 days; Median LOS for Group 2 was 10 days. Group 1 had an estimated treatment cost of £1114.15 per patient; Group 2 had an estimated treatment cost of £2314.15 per patient. 7/10 Group 1 participants were provided with the hospital’s PEG information booklet at least one week prior to PEG insertion. A reduction in LOS, a RTT waiting time within 18 weeks and a lower estimated mean treatment cost were noted for Group 1 participants. Expansion of the exploratory study is required so the objectives generated can be challenged further.
Advisors:
Fallows, Stephen; Wolfendale, Christine
Publisher:
University of Chester
Publication Date:
2014
URI:
http://hdl.handle.net/10034/345816
Type:
Thesis or dissertation
Language:
en
Appears in Collections:
Masters Dissertations

Full metadata record

DC FieldValue Language
dc.contributor.advisorFallows, Stephenen
dc.contributor.advisorWolfendale, Christineen
dc.contributor.authorEckersley, Deborahen
dc.date.accessioned2015-03-02T11:34:39Zen
dc.date.available2015-03-02T11:34:39Zen
dc.date.issued2014en
dc.identifier.urihttp://hdl.handle.net/10034/345816en
dc.description.abstractThe number of adult patients in the community receiving enteral feeding via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in relation to PEG were highlighted by a community multidisciplinary team including delayed referrals and discharges. The study aimed to explore retrospectively outcomes in relation to PEG insertion following the implementation of a pilot community PEG placement care pathway. The number of adult patients in the community receiving enteral feeding via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in relation to PEG were highlighted by a community multidisciplinary team including delayed referrals and discharges. The study aimed to explore retrospectively outcomes in relation to PEG insertion following the implementation of a pilot community PEG placement care pathway.The number of adult patients in the community receiving enteral feeding via a percutaneous endoscopic gastrostomy (PEG) is increasing. Identified problems in relation to PEG were highlighted by a community multidisciplinary team including delayed referrals and discharges. The study aimed to explore retrospectively outcomes in relation to PEG insertion following the implementation of a pilot community PEG placement care pathway. Data were analysed for a sample of participants over 18 years of age in three communities, served by a district general hospital in the North West of England. Group 1; ten participants managed on the community PEG placement care pathway and Group 2; ten participants who were not managed on community PEG placement care pathway with a similar primary diagnosis to Group 1. PEG insertion required to maintain nutritional status, hydration and/or medication administration for greater than fourteen days. Group 1 data for referral to treatment (RTT) waiting time was compared with the National Health Service (NHS) RTT waiting times for gastroenterology. Group 1 data for length of stay (LOS) following PEG insertion was compared to Group 2 data by conducting an Independent t‐test to analyse LOS between the two groups. A measure of central tendency obtained for LOS for Group 1 and Group 2 data was used in the calculation to estimate treatment cost. Group 1 data to estimate treatment cost was compared to Group 2 data by conducting an Independent t‐test to analyse treatment cost between the two groups. Data collection was obtained to establish if the hospital’s PEG information booklet was provided prior to PEG insertion. 6/10 participants in Group 1 had a RTT waiting time of 1 to 58 days. Median LOS for Group 1 was 4 days; Median LOS for Group 2 was 10 days. Group 1 had an estimated treatment cost of £1114.15 per patient; Group 2 had an estimated treatment cost of £2314.15 per patient. 7/10 Group 1 participants were provided with the hospital’s PEG information booklet at least one week prior to PEG insertion. A reduction in LOS, a RTT waiting time within 18 weeks and a lower estimated mean treatment cost were noted for Group 1 participants. Expansion of the exploratory study is required so the objectives generated can be challenged further.en
dc.language.isoenen
dc.publisherUniversity of Chesteren
dc.subjectmalnutritionen
dc.subjectenteral nutritionen
dc.subjectendoscopic gastrostomyen
dc.titleMalnutrition, enteral nutrition and the use of the percutaneous endoscopic gastrostomyen
dc.typeThesis or dissertationen
dc.type.qualificationnameMScen
dc.type.qualificationlevelMasters Degreeen
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