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Helping the general physician to improve outcomes after PEG insertion: how we changed our practice
L C Skitt1, J J Hurley, J K Turner
1Royal United Hospital, Bath. lcs123@doctors.org.uk
Clinical Medicine (London, England)
|April 30, 2011
Summary
Implementing a nurse-led pre-assessment service and targeted physician education for percutaneous endoscopic gastrostomy (PEG) insertion significantly improved patient selection and reduced 30-day mortality rates.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Healthcare Management
Background:
- Percutaneous endoscopic gastrostomy (PEG) insertion is a common procedure for general physicians.
- Challenges include suboptimal patient selection and unfavorable outcomes.
- There is a need to optimize PEG services and improve patient outcomes.
Purpose of the Study:
- To identify and address issues in PEG insertion decision-making and outcomes.
- To improve patient selection and reduce mortality rates associated with PEG procedures.
- To evaluate the impact of service changes on PEG referrals and outcomes.
Main Methods:
- A radical eight-year overhaul of the PEG service at University Hospital Llandough.
- Introduction of a nurse-led pre-assessment service for PEG referrals.
- Development of a specific referral form and implementation of formal physician education sessions.
Main Results:
- Reduced number of PEG referrals.
- Significant reduction in the 30-day mortality rate post-PEG insertion.
- Improved patient selection for PEG procedures.
Conclusions:
- A multidisciplinary approach involving nurse-led assessment and targeted education enhances PEG services.
- Optimized patient selection and service improvements lead to better clinical outcomes.
- The revised PEG service model positively impacted patient care and reduced mortality.
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