RESUMEN
Feeding initiation after percutaneous endoscopic gastrostomy tube insertion might occur anywhere from 4 to 24 hours after insertion in the practice setting. A review and appraisal of the literature reveals that feeding initiation is both safe and prudent within 4 hours of placement. Early feeding initiation allows for medications and nutrition to be given by enteral means earlier, resulting in a cost benefit for facilities and allowing patients to be discharged home or transferred to long-term care sooner. Nursing theory supports early feeding after percutaneous endoscopic gastrostomy tube placement. Early feedings provide patients with relief of their hunger and allow the patients and caregivers to move forward with the next level of care in their recovery.
Asunto(s)
Ingestión de Alimentos , Endoscopía/métodos , Nutrición Enteral/métodos , Gastrostomía/métodos , Práctica Clínica Basada en la Evidencia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Factores de Tiempo , Resultado del TratamientoRESUMEN
Pathogen transmissions via flexible endoscopes have been documented in the literature and have been historically related to human error or omission of steps in the reprocessing cycle. The 2008 Centers for Disease Control and Prevention report challenged manufacturers of automated endoscope reprocessors to improve and advance technology to automate more of the reprocessing steps. A review and synthesis of the literature following the 2008 Centers for Disease Control and Prevention report was performed to evaluate whether advances in reprocessing technology have occurred and whether these have had an impact on pathogen transmission via flexible endoscopes. The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to guide the project. The literature search regarding pathogen transmission related to flexible endoscopes yielded 10 documents citing infections from 2008 to 2015. A total of 353 patients were identified as having been infected with a contaminated gastroscope, bronchoscope, or duodenoscope. An evaluation of reprocessing technology identified 3 automated endoscope reprocessors with enhanced capabilities and flushing devices intended to automate portions of the manual cleaning step.
