1. Utilizing a Home Tube Feeding Protocol: Enhancing Continuity of Care in the SCI/D Veteran Population Kelly Skinner, MSN, RN, CRRN, WCC, CFCN, NP-C, GNP-BC; Tracey Presley, MSW, LICSW; Angela DiTucci, RDN, LDN; and Nancy Brooks, BSN, RN-BC, CRRN, CFCN, WCC. VA Boston Healthcare System
Dietitian
Social Worker
Nursing/Case Manager
Objectives:
1. To enhance the clinician’s knowledge on the current standards and practices related to home tube feeding.
2. Describe how the Home Tube Feeding Protocol was implemented at the VA Boston Healthcare System for SCI/D Veterans.
Background: According to the Office of Inspector General (OIG) Report, 27 VHA facilities were evaluated to determine compliance with the Joint Commission standards and the VHA requirements related to establishing and implementing tube feeding policies/practices, managing and documenting tube feeding in the medical record, and providing continuity of care for patients receiving tube feeding. Consequently, the OIG issued recommendations and the VHA Central Office Interdisciplinary Enteral Nutrition (EN) Task Force was responsible for addressing these recommendations to develop a training module which could be utilized by VA facilities.
Design: The Home Tube Feeding Protocol was designed so that seamless communication of the plan between inpatient and outpatient ensures a successful transition home. Is your SCI/D Veteran/caregiver ready for home tube feeding?
Methods: The Home Tube Feeding Protocol is an inter-professional process where nutrition, social work, case management, and nursing templates were developed. Education tools were created to allow for consistent team teaching so the Veteran and caregiver can demonstrate competency, knowledge and teach-back related to tube feeding.
Results: This poster presentation will illustrate how the Home Tube Feeding Protocol was rolled out at the VA Boston Healthcare System in order to ensure the SCI/D Veterans receive safe and effective tube feeding if they are unable to meet nutritional needs by oral intake or when oral intake might be contraindicated.
Conclusions: The SCI Center at VA Boston Healthcare System strives to put policy into practice to ensure the SCI/D Veteran receiving tube feeding and the caregiver has an optimal discharge to home. The continuity of care from inpatient to outpatient is maintained so that the Veteran’s tube feeding goals are achieved, monitored and adjusted as needed. Future research is needed to focus on veteran centered outcomes such as veteran satisfaction, staff satisfaction, decreased readmission rates and decreased home tube feeding complications and challenges.
Support: N/A