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Published on: January 17, 2011
Temporary feeding tube dependency in pediatric patients: A retrospective analysis of risk factors and preventative
Regina Tilyard1, Claire Reilly2, Danielle Gallegos3
1School of Nutrition and Exercise Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia.
Insights
Prolonged temporary tube feeding in children risks dependency. High-risk pediatric patients often don't receive preventative care, necessitating improved practices to reduce tube dependency.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Healthcare Quality Improvement
Background:
- Prolonged temporary tube feeding poses a risk of long-term feeding tube dependency in pediatric patients.
- Current practices for temporary tube feeding in Australian tertiary hospitals require evaluation.
- Identifying risk factors for prolonged tube feeding is crucial for intervention.
Purpose of the Study:
- To audit temporary tube feeding practices in a tertiary Australian hospital.
- To identify risk factors associated with prolonged temporary tube feeding in children.
- To assess the uptake of preventative practices for tube dependency in high-risk pediatric patients.
Main Methods:
- Retrospective chart audit of 187 pediatric inpatients with temporary feeding tubes (Nov 2014 - Mar 2017).
- Analysis of patient demographics and feeding tube practices.
- Utilized Kaplan-Meier estimates, Cox, and logistic regression to identify predictors and preventative practice utilization.
Main Results:
- Median temporary tube feeding duration was 6.43 months.
- Predictors of prolonged feeding included prematurity, feeding difficulties, and referral for long-term tubes.
- Preventative practices like documented exit plans (5.3%) and long-term tube referrals (27.3%) were low, with no increased likelihood in high-risk patients.
Conclusions:
- Extended temporary tube feeding duration in pediatric patients is evident.
- There is a clear need to enhance the implementation of tube dependency preventative practices, particularly for high-risk pediatric groups.
Background & Aims:
Prolonged temporary tube feeding places pediatric patients at risk of tube dependency. This chart audit aimed to identify current temporary tube feeding practice within an Australian tertiary hospital, risk factors of prolonged temporary tube feeding, and the likelihood of high risk patients receiving tube dependency preventative practices.
Methods:
A retrospective chart audit was conducted of the medical records of 187 pediatric inpatients who had temporary feeding tubes placed in an Australian tertiary hospital between November 2014 and March 2017. Information was collected on patient demographics and tube feeding practices. The Kaplan Meier estimate, Cox regression and logistic regression were used to determine the median time until feeding tube removal, predictors of prolonged temporary tube feeding, and the relationship between these predictors and utilization of preventative practices.
Results:
The Kaplan Meier estimate of median tube feeding duration was 6.43 months (95% CI: 5.17-7.90). Predictors of prolonged tube feeding were prematurity (p = 0.003), feeding difficulties requiring speech pathology referral (p = 0.002), and referral for long-term feeding tubes (p = 0.002). There was a low prevalence of preventative clinical practices including documentation of tube exit plans (5.3%, n = 10) and referral for long-term feeding tubes (27.3%, n = 51). Exhibiting risk factors for prolonged tube feeding did not increase the likelihood of receiving preventative clinical practices.
Conclusions:
The prolonged duration of temporary tube feeding within this sample highlights the need for improved utilization of tube dependency preventative practices within high risk groups.
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