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Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses
Author(s) -
Lim Mei Ling,
Yong Bei Yi Paulynn,
Mar Mei Qi Maggie,
Ang Shin Yuh,
Chan Mei Mei,
Lam Madeleine,
Chong Ngian Choo Janet,
Lopez Violeta
Publication year - 2018
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14347
Subject(s) - medicine , focus group , constipation , nursing , parenteral nutrition , enteral administration , acute care , family medicine , health care , intensive care medicine , surgery , marketing , business , economics , economic growth
Aims and objectives To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. Background The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. Methods A mixed‐method approach was adopted. (i) A face‐to‐face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Results Ninety‐nine carers ( n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years ( SD = 11.2), and they had been on enteral feeding for a mean of 29 months ( SD = 23.0). Most were bed‐bound (90%) and required full assistance with their feeding (99%). Most were not on follow‐up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses ( n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. Conclusion To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. Relevance to clinical practice This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition.