Dinenage Sarah, Gower Morwenna, Van Wyk Joanna, Blamey Anne, Ashbolt Karen, Sutcliffe Michelle, Green Sue M
University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, SO16 6YD, UK.
Solent NHS Trust, Adelaide Health Centre, Western Community Hospital Campus, Southampton, SO16 4XE, UK.
Nutrients. 2015 Mar 5;7(3):1607-17. doi: 10.3390/nu7031607.
The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.
为支持越来越多在家接受肠内管饲（ETF）的人群而提供的服务组织在不同地区存在差异。有证据表明，专注于家庭肠内营养（HEN）的多学科初级保健团队能够提供具有成本效益的护理。本文描述了英国一个城市中一个HEN团队的发展与评估情况。一个由营养师、护士和言语治疗师组成的HEN团队成立，旨在为居家使用胃造口管的患者提供优质服务。设定了团队目标，并制定了一个包括护理路径和培训计划的基础组织框架。在前后测试评估设计中评估了对患者结局的影响。患者和护理人员报告称在管理ETF方面得到了更好的支持。通过以下方式实现了成本节约：（1）预防因ETF相关问题导致的住院及相关交通费用；（2）有效管理并减少喂养液和增稠剂的浪费；（3）HEN团队在患者家中更换球囊胃造口管，并优化营养状况。这项服务评估表明，建立一个专注于实现关键目标的专业多学科HEN团队改善了患者体验，尽管成本节约的计算是估算值，但提供了成本效益的证据。
