Percutaneous feeding tube changes in long-term-care facility patients.

OBJECTIVE

To compare patient outcomes when percutaneous feeding tubes were changed routinely each month or only when necessary (prn).

DESIGN

Prospective, randomized, nonblinded crossover study of 6 months of routine monthly changes compared with 6 months of prn changes.

SETTING

416-bed long-term-care facility.

PATIENTS

26 permanent residents with nutrition managed through percutaneous gastrostomy or jejunostomy feeding tubes. The median age was 61.5 years; 8 (31%) also had tracheostomies, and 3 (12%) had indwelling urinary catheters.

RESULTS

The frequency of feeding tube changes was 40 per 1,000 patient-days during the 6 months of routine tube changes and 14 per 1,000 when tubes were changed prn (P < .001). There were no differences between the two study periods in frequency of stoma site infections, fever, episodes of emesis, and total antibiotic courses. The median duration in situ of feeding tubes with prn changes was 104 days. For both periods, feeding tubes were significantly more likely to fall out and require replacement with-in 24 hours of previous tube replacement.

CONCLUSION

There were no observed differences in clinical outcomes in long-term-care facility patients when feeding tubes were changed only as necessary as compared to routine monthly changes.