Mrs Shelly Casey1, Miss Anna Page
1Illawarra Shoalhaven Local Health, Port Kembla, Australia
Biography:
Shelly Casey & Anna Page
Aged Care Clinical Lead Dietitians, Illawarra Shoalhaven Local Health District (LHD)
Shelly Casey and Anna Page are Aged Care Clinical Lead Dietitians at Illawarra Shoalhaven Local Health District, specializing in the management of home enteral feeding for patients in the community. In their roles, they provide essential nutrition care and support to individuals requiring tube feeding, working closely with healthcare teams, patients, and families to ensure safe and effective feeding practices at home.
Abstract:
Introduction:
Home enteral nutrition (HEN) provides essential nutrition through feeding tubes for individuals unable to eat orally. However, the experiences of patients with feeding tubes in the Illawarra Shoalhaven Local Health District (ISLHD) remain underexplored. This study aims to investigate the barriers and challenges faced by patients managing HEN and identify opportunities for improving care within the ISLHD.
Methods:
A mixed-methods approach was employed, combining semi-structured interviews and a retrospective medical record audit. Eight participants with feeding tubes in situ were interviewed, with discussions audio-recorded, transcribed verbatim, and analysed. The audit reviewed tube complication and troubleshooting data from electronic medical records for 48 patients receiving nutrition care from an ISLHD Dietitian.
Results:
Five key themes emerged: initial experiences with feeding tubes, challenges in managing HEN, difficulties navigating healthcare services, frustrations with service accessibility, and long-term care navigation. Participants reported insufficient education, feelings of being overwhelmed, and a lack of coordinated support, often leading to reliance on emergency services. Notably, 47.5% of participants sought emergency care for tube-related issues within the first year post-insertion.
Conclusion:
This study highlights significant gaps in care, emphasizing the need for improved education and support for patients managing HEN. To address these gaps, it is recommended that community dietitians in ISLHD have an enhanced scope of practice, including training in tube replacements. This would enable dietitians to provide more comprehensive care, reduce reliance on emergency services, and improve overall patient outcomes in the community setting.