title: Percutaneous feeding tube changes in long-term-care facility patients.
abstract: OBJECTIVE
  To compare patient outcomes when percutaneous feeding tubes were changed routinely each month or only when necessary (prn).
  
  
  METHODS
  Prospective, randomized, nonblinded crossover study of 6 months of routine monthly changes compared with 6 months of prn changes.
  
  
  METHODS
  416-bed long-term-care facility.
  
  
  METHODS
  26 permanent residents with nutrition managed through percutaneous gastrostomy or jejunostomy feeding tubes. The median age was 61.5 years; 8 (31%) also had tracheostomies, and 3 (12%) had indwelling urinary catheters.
  
  
  RESULTS
  The frequency of feeding tube changes was 40 per 1,000 patient-days during the 6 months of routine tube changes and 14 per 1,000 when tubes were changed prn (P < .001). There were no differences between the two study periods in frequency of stoma site infections, fever, episodes of emesis, and total antibiotic courses. The median duration in situ of feeding tubes with prn changes was 104 days. For both periods, feeding tubes were significantly more likely to fall out and require replacement with-in 24 hours of previous tube replacement.
  
  
  CONCLUSIONS
  There were no observed differences in clinical outcomes in long-term-care facility patients when feeding tubes were changed only as necessary as compared to routine monthly changes.
authors.affiliation: Deer Lodge Centre, Winnipeg, Manitoba, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Graham
authors.forename: G
authors.initials: G
authors.lastname: Sim
authors.forename: R
authors.initials: R
authors.lastname: Laughren
authors.forename: J
authors.initials: J
authors.lastname: Chicoine
authors.forename: E
authors.initials: E
authors.lastname: Stephenson
authors.forename: G
authors.initials: G
authors.lastname: Leche
authors.forename: M
authors.initials: M
authors.lastname: McIntyre
authors.forename: D
authors.initials: D
authors.lastname: Murray
authors.forename: F Y
authors.initials: FY
authors.lastname: Aoki
authors.forename: L E
authors.initials: LE
authors.lastname: Nicolle
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D018592:Cross-Over Studies; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects* / Q000451:nursing; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007582:Jejunostomy / Q000009:adverse effects* / Q000451:nursing; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012866:Skilled Nursing Facilities