“As the complexity of home care increases and more is demanded of patients with regards to their healthcare needs, the role of patient education becomes ever more important,” NCP, Oct 2010, H.Gifford RD, DeLegge MD, Epperson RN.
I found this quote as I was perusing the website for the Oley Foundation. An incredible non-profit organization, with its mission to help those on home nutrition therapy (known to clinicians as Enteral and Parenteral Nutrition) through education, advocacy, and networking. It also is a resource to both families and clinicians alike. For example, it has a page sharing various methods of feeding through your tube, as well as how to safely give medications through your tube. https://oley.org/page/TF_Troubleshooting
I look at this quote, and I think that this was written 12 years ago. Since this article was published, I think of the pressure to discharge patients faster. I think of the pressure to see more patients in clinic in less time. I think of what patients go through that have never seen a tube before and the next day (or often the same day!) they have a tube placed and sent out the door with little information. They are expected to know how to care for the tube, and how to troubleshoot tolerance of their tube feeding- which they are dependent on in order to stay hydrated, thrive… and survive.
Did you know that CMS.gov has published that increased complications, prolonged hospital stays and readmission accounts for an annual US economic burden of $157 billion? Did you know that patients that don’t get sound education and follow-up for their home tube feeding fall into all these categories- increased complications from malnutrition and tube site infections, prolonged hospital stays as well as readmissions. Two studies published (Hall et al, 2014, NCP & Emmons, 2022, NCP) have shown that improving tube education in conjunction with increased RD follow up markedly reduces ER visits, readmissions and tube complications.
So why isn’t this being done everywhere as a national standard? Unfortunately, this costs MONEY. Who is going to pay? Currently, Medicare does not cover the cost of nutrition intervention by a dietitian for home nutrition support patients. In a more and more stretched healthcare economy, finding the funding for such services is hard to come by. And it is the patient and their families that suffer the cost.
If nothing else, I would love to have Enteral support patients who are at home on tube feedings. I want to give them the expertise they deserve. I want to give them the time it takes to research every case, because nutrition is a science, not a second thought. I want to give the time required for continued follow up, for continued troubleshooting and tweaking, because that is what it takes to get patients where they need to be. I want to give them a better quality of life, keep them out of the ICU and help assure their caregivers they are doing what they need to do to care for their loved ones. If this sounds like something you are interested in, please reach out to us at Enteral.
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