Margaret B. Mitchell , Kevin Callans , Carmina Erdei , Siliva Patrizi , Lauren Fiechtner , Cassandra Kelleher , Allan M. Goldstein , Paul Lerou , Rodica Turcu , Mary Fracchia , Marcella Radano , Pamela Dodrill , Jessica Sorbo , Cheryl Hersh , Mollie Warren , Christopher Hartnick
{"title":"新生儿家庭鼻胃管护理的多机构质量改进算法","authors":"Margaret B. Mitchell , Kevin Callans , Carmina Erdei , Siliva Patrizi , Lauren Fiechtner , Cassandra Kelleher , Allan M. Goldstein , Paul Lerou , Rodica Turcu , Mary Fracchia , Marcella Radano , Pamela Dodrill , Jessica Sorbo , Cheryl Hersh , Mollie Warren , Christopher Hartnick","doi":"10.1016/j.ijporl.2024.112083","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>High-risk neonates continuing to need enteral nutrition, but otherwise medically ready for discharge home from the NICU, are often offered ongoing hospitalization for nasogastric tube (NGT) feeding, versus discharge after placement of gastrostomy tube. Our group developed an interdisciplinary algorithm to support a third option—discharge home with enteral nutrition via NGT. Our objective was to develop a cross-institutional and interdisciplinary pathway to optimize outcomes for neonates discharged with NGTs.</p></div><div><h3>Methods</h3><p>A program to support home NGT feeding use was created, “Passport Home Program,” based upon feedback from parents, nurses, speech-language pathologists, otolaryngologists, and neonatal intensivists, amongst others, spanning four hospitals across our health system.</p></div><div><h3>Results</h3><p>Standardized educational materials for caregivers of neonates requiring ongoing NGT feeding on discharge were created and consist of an in-hospital curriculum with specific competency thresholds, including demonstrating NGT replacement and confirmation with pH test strips. A discharge kit, including a QR code for a video reviewing safe techniques for home NGT placement, is distributed, along with support staff contact information. Members of an emergency department were trained in neonatal NGT replacement in case of issues after business hours. Each patient is followed in a dedicated outpatient multi-disciplinary clinic.</p></div><div><h3>Discussion</h3><p>This is an interdisciplinary and multi-institutional effort to standardize a pathway for neonates discharged home from the NICU with NGTs. This has the potential to lead to earlier discharge, better outcomes for patients and families, as well as lower costs. This best practice algorithm serves as an example pathway applicable across fields of medicine.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multi-institutional quality improvement algorithm for home nasogastric tube care for neonates\",\"authors\":\"Margaret B. Mitchell , Kevin Callans , Carmina Erdei , Siliva Patrizi , Lauren Fiechtner , Cassandra Kelleher , Allan M. Goldstein , Paul Lerou , Rodica Turcu , Mary Fracchia , Marcella Radano , Pamela Dodrill , Jessica Sorbo , Cheryl Hersh , Mollie Warren , Christopher Hartnick\",\"doi\":\"10.1016/j.ijporl.2024.112083\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>High-risk neonates continuing to need enteral nutrition, but otherwise medically ready for discharge home from the NICU, are often offered ongoing hospitalization for nasogastric tube (NGT) feeding, versus discharge after placement of gastrostomy tube. Our group developed an interdisciplinary algorithm to support a third option—discharge home with enteral nutrition via NGT. Our objective was to develop a cross-institutional and interdisciplinary pathway to optimize outcomes for neonates discharged with NGTs.</p></div><div><h3>Methods</h3><p>A program to support home NGT feeding use was created, “Passport Home Program,” based upon feedback from parents, nurses, speech-language pathologists, otolaryngologists, and neonatal intensivists, amongst others, spanning four hospitals across our health system.</p></div><div><h3>Results</h3><p>Standardized educational materials for caregivers of neonates requiring ongoing NGT feeding on discharge were created and consist of an in-hospital curriculum with specific competency thresholds, including demonstrating NGT replacement and confirmation with pH test strips. A discharge kit, including a QR code for a video reviewing safe techniques for home NGT placement, is distributed, along with support staff contact information. Members of an emergency department were trained in neonatal NGT replacement in case of issues after business hours. Each patient is followed in a dedicated outpatient multi-disciplinary clinic.</p></div><div><h3>Discussion</h3><p>This is an interdisciplinary and multi-institutional effort to standardize a pathway for neonates discharged home from the NICU with NGTs. This has the potential to lead to earlier discharge, better outcomes for patients and families, as well as lower costs. This best practice algorithm serves as an example pathway applicable across fields of medicine.</p></div>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2024-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0165587624002374\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165587624002374","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
Multi-institutional quality improvement algorithm for home nasogastric tube care for neonates
Background
High-risk neonates continuing to need enteral nutrition, but otherwise medically ready for discharge home from the NICU, are often offered ongoing hospitalization for nasogastric tube (NGT) feeding, versus discharge after placement of gastrostomy tube. Our group developed an interdisciplinary algorithm to support a third option—discharge home with enteral nutrition via NGT. Our objective was to develop a cross-institutional and interdisciplinary pathway to optimize outcomes for neonates discharged with NGTs.
Methods
A program to support home NGT feeding use was created, “Passport Home Program,” based upon feedback from parents, nurses, speech-language pathologists, otolaryngologists, and neonatal intensivists, amongst others, spanning four hospitals across our health system.
Results
Standardized educational materials for caregivers of neonates requiring ongoing NGT feeding on discharge were created and consist of an in-hospital curriculum with specific competency thresholds, including demonstrating NGT replacement and confirmation with pH test strips. A discharge kit, including a QR code for a video reviewing safe techniques for home NGT placement, is distributed, along with support staff contact information. Members of an emergency department were trained in neonatal NGT replacement in case of issues after business hours. Each patient is followed in a dedicated outpatient multi-disciplinary clinic.
Discussion
This is an interdisciplinary and multi-institutional effort to standardize a pathway for neonates discharged home from the NICU with NGTs. This has the potential to lead to earlier discharge, better outcomes for patients and families, as well as lower costs. This best practice algorithm serves as an example pathway applicable across fields of medicine.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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