Characterisation of hospital-produced guidelines regarding management of temporary tube feeding care in general paediatric patients

Abstract

Background/Aims There is significant variation in the implementation of temporary tube feeding management in children and a paucity of associated clinical practice guidelines covering all phases of care, from decision making regarding tube insertion through to tube weaning. Development of clinical practice guidelines should consider levels of evidence other than randomised control trials. Examining hospital-produced guidelines used by frontline health staff, for example, could distinguish areas of application of evidence-based recommendations, as well as domains of care in need of increased implementation. This article describes the content of existing hospital-produced guidelines relating to tube feeding care in a general paediatric population. Methods Hospital-produced guidelines were sought by mailing 200 health services worldwide and searching Queensland Health's Electronic Publishing Service in Australia and Google. A content analysis was then performed. Results The 13 collected hospital-produced guidelines from Australia, the UK and Canada generally comprehensively reported on processes related to the decision-making, tube placement and tube maintenance phases. However, reporting on oral feeding while tube feeding, tube feeding dependency, tube feeding exit planning, and the social and emotional aspects of tube feeding were areas within these phases that had limited coverage. Recommendations for the phase of tube weaning were also infrequently included. Conclusions Development of formal clinical practice guidelines covering all tube feeding phases should assist in optimising patient and health service outcomes.