Patients with gastrostomy in the home. Follow-up by a home care support team
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Tordable Ramírez AM et al. Pacientes con gastrostomía en domicilio. Metas de Enferm mar 2011; 14(2): 10-14
Authors
Ana Mª Tordable Ramírez, Eva Mª Sanz Peces
Position
Enfermeras del Equipo de Soporte de Atención Domiciliaria (ESAD). Dirección Asistencial Norte, Madrid.
Contact address
Ana Mª Tordable Ramírez. Centro de Salud Reyes Católicos. Avda. de España, 20. 28700 San Sebastián de los Reyes (Madrid).
Contact email: atordable.gapm05@salud.madrid.org
Abstract
Objective: to define the profile of the patient with gastrostomy in the home. To analyse the most frequent associated complications. To determine which patients have prior instructions. To identify the healthcare professional who changes the gastrostomy catheter in the home.
Material and methods: cross-sectional, descriptive, observational study. Patients from the North Madrid Healthcare Area with a gastrostomy catheter in the home and under follow-up by the HCST (Home Care Support Team). Analysed variables: age, sex, area of care, origin of referral, diagnosis, days of follow-up, number of catheter changes, professional who performed the change, minor and major complications, type of enteral nutrition, Schedule, participation of Primary Care, primary caregiver, whether they had prior instructions and discharge reason.
Results: 46 patients who were immobilized in the home and had a gastrostomy catheter. Mean age was 60,02 years. 58,7% were women. 58,7% were diagnosed with neurological disease. The most frequent minor complications were gastrointestinal (31,1%) and the most frequent major complication was peritonitis 2,17%. The primary caregiver was a woman in 69,5% of cases. 17,7% had previous instructions. 67,4% received follow-up from the HCST until their death. The HCST nurse performed the gastrostomy catheter change in 81% of cases.
Conclusions: the profile of the patient who has a gastrostomy in the home is a woman around the age of 60, with neurological disease and whose primary caregiver is a woman. The most frequent complications are gastrointestinal (constipation/diarrhoea). Patients with neurological diseases carry out prior instructions more frequently. The HCST nurse changes the gastrostomy catheter in the home. Based on the low involvement of Primary Care professionals, it would be advisable for the HCST to develop a training project for these professionals on the care of gastrostomy patients.
Material and methods: cross-sectional, descriptive, observational study. Patients from the North Madrid Healthcare Area with a gastrostomy catheter in the home and under follow-up by the HCST (Home Care Support Team). Analysed variables: age, sex, area of care, origin of referral, diagnosis, days of follow-up, number of catheter changes, professional who performed the change, minor and major complications, type of enteral nutrition, Schedule, participation of Primary Care, primary caregiver, whether they had prior instructions and discharge reason.
Results: 46 patients who were immobilized in the home and had a gastrostomy catheter. Mean age was 60,02 years. 58,7% were women. 58,7% were diagnosed with neurological disease. The most frequent minor complications were gastrointestinal (31,1%) and the most frequent major complication was peritonitis 2,17%. The primary caregiver was a woman in 69,5% of cases. 17,7% had previous instructions. 67,4% received follow-up from the HCST until their death. The HCST nurse performed the gastrostomy catheter change in 81% of cases.
Conclusions: the profile of the patient who has a gastrostomy in the home is a woman around the age of 60, with neurological disease and whose primary caregiver is a woman. The most frequent complications are gastrointestinal (constipation/diarrhoea). Patients with neurological diseases carry out prior instructions more frequently. The HCST nurse changes the gastrostomy catheter in the home. Based on the low involvement of Primary Care professionals, it would be advisable for the HCST to develop a training project for these professionals on the care of gastrostomy patients.
Keywords:
enteral nutrition in the home; epidemiology; gastrostomy; HCST; home; Primary Careprior instructions
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