Show simple item record

dc.contributor.authorBurgermaster, Marissa
dc.contributor.authorSlattery, Eoin
dc.contributor.authorIslam, Nafeesa
dc.contributor.authorIppolito, Paul R.
dc.contributor.authorSeres, David S.
dc.date.accessioned2018-09-20T16:02:01Z
dc.date.available2018-09-20T16:02:01Z
dc.date.issued2016-03-18
dc.identifier.citationBurgermaster, Marissa; Slattery, Eoin; Islam, Nafeesa; Ippolito, Paul R. Seres, David S. (2016). Regional comparison of enteral nutrition–related admission policies in skilled nursing facilities. Nutrition in Clinical Practice 31 (3), 342-348
dc.identifier.issn0884-5336,1941-2452
dc.identifier.urihttp://hdl.handle.net/10379/10597
dc.description.abstractBackground: Nursing home admission policies are one driver of increased and earlier gastrostomy placement, a procedure that is not always medically or ethically indicated among patients needing short-term nutrition support. This important clinical decision should be based upon patient prognosis, goals, and needs. We compared nursing home enteral nutrition-related admission policies in New York City and other regions of the United States. We also explored motivations for these policies. Methods: We conducted a telephone survey with skilled nursing facility administrators in New York City and a random sample of facilities throughout the United States about enteral nutrition-related admission policies. Survey data were matched with publically available data about facility characteristics from the Centers for Medicare and Medicaid Services. The relationship between facility location and admission policies was described with regression models. Reasons for these policies were thematically analyzed. Results: New York City nursing homes were significantly less likely to admit patients with nasogastric feeding tubes than were nursing homes nationwide, after we controlled for facility characteristics (odds ratio = 0.111; 95% CI, 0.032-0.344). Reasons for refusing nasogastric tubes fell into 5 categories: safety, capacity, policy, perception of appropriate level of care, and patient quality of life. Conclusion: Our findings indicate that enteral nutrition-related admission policies vary greatly between nursing homes in New York City and nationwide. Many administrators cited safety and policy as factors guiding their institutional policies and practices, despite a lack of evidence. This gap in research, practice, and policy has implications for quality and cost of care, length of hospital stay, and patient morbidity and mortality.
dc.publisherSAGE Publications
dc.relation.ispartofNutrition in Clinical Practice
dc.subjectenteral nutrition
dc.subjectnursing homes
dc.subjectmedical ethics
dc.subjectnasogastric feeding
dc.subjectgastrostomy
dc.subjectpercutaneous endoscopic gastrostomy
dc.subjectadvanced cognitive impairment
dc.subjectin-hospital mortality
dc.subjectintensive-care-unit
dc.subjectfeeding-tube use
dc.subjecthome residents
dc.subjectadvanced dementia
dc.subjectplacement
dc.subjectpeg
dc.subjectcomplications
dc.titleRegional comparison of enteral nutrition–related admission policies in skilled nursing facilities
dc.typeArticle
dc.identifier.doi10.1177/0884533616629636
dc.local.publishedsourcehttp://europepmc.org/articles/pmc4875841?pdf=render
nui.item.downloads0


Files in this item

This item appears in the following Collection(s)

Show simple item record