title: Impact of the early initiation of feedings on hospital length of stay in children post-PEG tube placement.
abstract: Delays in feeding patients post-percutaneous endoscopic gastrostomy (PEG) tube placement may result in unnecessary prolongation of hospital stay, deprivation of nutrition, and increased healthcare costs. Common practice has been to wait overnight before initiating feedings post-PEG tube placement. Our facility changed existing policy and began feeding children 6 hours post-PEG. The objectives of this article are to (a) describe the effect of early feeding (6 hours postprocedure) on length of hospital stay, and (b) add to the existing data on safety of early feeding post-PEG tube placement in children. A retrospective chart review of 70 patients admitted for PEG tube placement was performed. Patients admitted pre- and postpolicy change were compared for length of hospitalization, time NPO (nothing by mouth), pain scores, pain medication use, and adverse events (Group A: before policy change; Group B: after policy change). No adverse events were identified in either group. Both median time to feeding initiation and hospital length of stay were shorter in Group B. There was no significant difference in reported pain scores or the number of pain medication doses between the two groups. Early initiation of feedings post-PEG led to a shortened length of hospital stay with no increase in adverse events or reported pain.
authors.affiliation: Fiona Paul, DNP, RN, CPNP, is Nurse Practitioner, Department of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts. Julia Perkins, MS, RN, CPNP, is Nurse Practitioner, Department of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts. Hongyu Jiang, PhD, is Biostatistician, Department of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts. Margaret McCabe, PhD, RN, CPNP, is Nurse Scientist, Department of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Fiona
authors.initials: F
authors.lastname: Paul
authors.forename: Julia
authors.initials: J
authors.lastname: Perkins
authors.forename: Hongyu
authors.initials: H
authors.lastname: Jiang
authors.forename: Margaret
authors.initials: M
authors.lastname: McCabe
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005248:Feeding Methods; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies