Day case gastrostomy placement for patients in the community

The numbers of patients receiving home enteral feeding via a gastrostomy is increasing, with placement of the gastrostomy often being undertaken as a hospital day case. There are a number of benefits to the patient having the procedure in this way, however, problems may arise if a comprehensive assessment is not undertaken prior to the procedure, there is a lack of communication between hospital and community services, or inappropriate or inadequate training. It is essential to ensure that the transfer of care from acute hospital to community services is thorough to minimize these potential problems. This article aims to address some of the pitfalls that may occur when patients who require home enteral feeding are admitted to hospital for the placement of a gastrostomy and discharged from hospital into their own homes or into a care home the same day. Discussion will centre around the timing and assessment for gastrostomy placement, managing the risk of refeeding syndrome, devising a suitable feed regime, obtaining prescriptions, setting up community services and monitoring the patient's progress.