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Tube Feeding Audit Reveals Hidden Costs and Risks of Current Practice

Silkroski, Marcia, Allen, Francine, Storm, Heidi
Nutrition in clinical practice 1998 v.13 no.6 pp. 283-290
hospitals, interviews, issues and policy, labor, nutrition risk assessment, patients, restricted feeding, tube feeding
A multidisciplinary audit at 11 teaching hospitals assessed hidden costs and quality issues related to tube feeding. Data were collected on 417 tube-fed patients via interviews and review of departmental records. Hospitals averaged 38 tube-fed patients per day and 13 different formulas. Average tube feeding duration was 8.1 days. Hidden costs were identified: 18% to 62% of formulas were wasted per patient per day. The mean annual cost of wasted tube feeding formula per facility was $26,846. Open systems required 14 min/patient/d to manage, compared with 2 min/patient/d for closed systems; the open system required additional administration sets, which cost each facility an average of $47,744 per year; 33% of feedings required additional labor for manipulations. Risks identified included underfeeding of prescribed volume, exceeding hang-time policy, and practices associated with bacterial risk. The audit addressed the need for multidisciplinary evaluation of tube feeding programs to reveal hidden costs and true practices.