Procedures for home enteral nutrition.

As emphasis on early hospital discharge increases, home tube feeding is becoming a popular method of efficiently delivering nutritional support. This paper describes the team approach to home enteral feeding practices at the Foothills Hospital in Calgary, Alberta. Three groups of patients are referred to the program: those who require tube feedings permanently as the sole means of nutrition; those who require supplementation from tube feedings; and those who temporarily require tube feeding. The dietitian selects an enteral formula suitble for the patient. Although continuous enteral feedings are generally better tolerated by patients, intermittent feedings may be more psychologically acceptable. Continuous feedings are initiated at 50 ml per hour and increased to approximately 150 ml per hour, depending upon patient tolerance and nutritional goals. Complications can result from mechanical problems (e.g. equipment failure) and metabolic/physiologic problems (e.g. constipation). A total of 35 patients have been taught the technique of home tube feeding. The program has been well accepted by patients and physicians.