Choosing wisely: Enteral feeding tube selection, placement, and considerations before and beyond the procedure room

Nutr Clin Pract. 2023 Apr;38(2):216-239. doi: 10.1002/ncp.10959.

Abstract

When an enteral feeding tube (EFT) is placed, it is not always known how long this nutrition support intervention will be needed. As a result, the type of device the patient originally has placed may not match the function it is required to serve or the lifestyle needs of the patient throughout their enteral nutrition journey. Medicare considers an EFT a prosthetic device, as it is replacing a permanently inoperable or nonfunctioning organ. If we think about an EFT the same way we think about a prosthetic limb, one that needs to be customized to meet all of the patient's functional and lifestyle needs, we can also begin to think beyond the procedure room and carefully consider a variety of factors that impact the patient at home receiving enteral nutrition. Proper fit, function, and style is essential in order for the patient to have a positive relationship with their EFT, contributing to their successful home enteral nutrition experience. Clinicians who care for these patients in any setting and in any capacity would benefit from enhancing their understanding of available EFT options, their design components, and available methods of placement. Many home care and outpatient clinicians adopt the role of patient advocate as it relates to a patient's enteral nutrition journey, and this expanded knowledge could be used to benefit the patient by improving their overall enteral nutrition experience and ultimately their relationship with their "prosthetic."

Keywords: enteral nutrition; feeding tubes; gastrostomy; home nutrition support; jejunostomy.

MeSH terms

  • Aged
  • Enteral Nutrition* / methods
  • Gastrostomy* / methods
  • Humans
  • Intubation, Gastrointestinal / methods
  • Jejunostomy
  • Medicare
  • United States