Babies and children that have an oral nutritional intake that fails to meet metabolic needs and which is not expected to resolve in 1 to 3 months’ time may have a gastrostomy insertion.
Like any interventional procedure, there is potential for complications [including chemical peritonitis, infection, bowel perforation, haemorrhage, and aspiration pneumonia] but prompt recognition of these complications with early action reduces the risk of serious harm or death. However, significant portions of the patient pathway involves care in the community where parents and carers of patients may be supported by a variety of professionals, some of whom can be relatively inexperienced with respect to the specialised needs of this patient cohort.
Following initial scoping with a group of parents, and process mapping and risk identification, the project has evolved into four separate quality improvement workstreams:
WS1 looks to support and empower parents [and carers] to deliver safe care through training and competency assurance. Co-produced training information materials are being developed for use by both hospital teams and community healthcare professionals [HCPs]. A training and competency booklet is in the final stages of production.
WS2 is focusing on up skilling the specialist HCPs who support parents of children with gastrostomies in the community. During Q2/18 a regional, multi-professional Shared Learning and Training event has been planned which will take place at MKUH on 12th October.
WS3 provides awareness training for the non-specialist HCPs in the region who patients may come into contact with during out-of-hours and emergency scenarios. An algorithm is being developed to support decision making.
WS4 looks to improve communications along the care pathways, both between HCPs, and between parents and HCPs. We aim to establish a regional Community of Practice to enable professionals of all disciplines who care for children in our programme to share practice, learning and experience and provide peer support.
Early detection of complications after gastrostomy, NHS Direct Alert, March 2010