Think Twice Before Inserting That Feeding Tube

By Shawn Kennedy, AJN interim editor-in-chief


One of the news stories in the May issue of AJN describes the “down the road” implications for a common practice—the use of feeding tubes in patients with end-stage dementia. Feeding tubes are often placed in these patients in the acute care setting and remain as the patient moves to a nursing home for continued care.

“Feeding Tubes Used Too Often in End-Stage Dementia” discusses a study recently published in JAMA that sought to examine this practice and identify what factors are associated with its continued use “despite a body of literature showing that they aren’t effective in improving clinical outcomes or survival.”

This is an important read as it reminds us to question why we do what we do, how it will improve or enhance outcomes, and what are the implications of intervening versus not intervening? Do we “follow the protocol” because it’s convenient, or do we look ahead at implications for patients and families?

So how does your hospital stack up?

Bookmark and Share

2016-11-21T13:17:48-05:00May 6th, 2010|nursing research|0 Comments
Read More

What to Teach Patients and Their Families About Asthma

What do you need to know about asthma, and what should you teach your patients about its prevention and management? This month’s CE article gives a comprehensive and accessible overview, with medication, symptom, and common allergen tables, as well as advice like the following about the use of “action plans,” which may be particularly helpful with patients with “moderate or severe persistent asthma, a history of exacerbations, or poorly controlled asthma.” 

Action plans should be simple and easy to use. Many use a traffic light analogy, describing green, yellow, and red zones for which specific actions are prescribed. In the green (“go”) zone, patients’ [peak expiratory flow rate] PEFR is 80% to 100% of their personal best and they have no symptoms. These patients can continue using their daily medications and taking steps to limit exposure to triggers, as described in their plan. When patients’ PEFR is 50% to 80% of their personal best and they have symptoms, they’ve entered the yellow (“caution”) zone, and practitioners may consider prescribing alternative antiinflammatory medications and, possibly, a higher dose or more frequent use of the rescue medication. Patients whose PEFR drops below 50% of their personal best and whose symptoms fail to improve significantly with prescribed rescue medications are in the red (“danger–stop”) zone. They should increase medication as indicated in their action plan and call their health care provider immediately. If unable to reach their provider, they should stop what they’re […]

2016-11-21T13:17:49-05:00May 6th, 2010|nursing perspective|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top