Implementing EBN, It’s Not as Straightforward as It Seems: Chronic enteral nutrition for persons with severe cognitive impairments

2.50
Hdl Handle:
http://hdl.handle.net/10755/151661
Type:
Presentation
Title:
Implementing EBN, It’s Not as Straightforward as It Seems: Chronic enteral nutrition for persons with severe cognitive impairments
Abstract:
Implementing EBN, It’s Not as Straightforward as It Seems: Chronic enteral nutrition for persons with severe cognitive impairments
Conference Sponsor:Sigma Theta Tau International
Conference Year:2004
Conference Date:July 22-24, 2004
Author:Hughes, Anne M., RN, MN, FAAN
Title:Advanced Practice Nurse, Palliative Care
Co-Authors:Bronwyn Gundogdu, RN; Mary McCutcheon, RN, MS
In recent years, there is growing evidence questioning the use of long term enteral nutrition for persons with severe cognitive impairments such as Alzheimers’ Dementia (Finucane, et al. 1999). Enteral nutrition in this patient population has not increased survival nor decreased morbidity. In the U. S., several highly publicized cases involving the use of enteral nutrition as a life prolonging intervention for persons in persistent vegetative state (i.e. Nancy Cruzan, Terri Schiavo) have even influenced public policy. In 1999, over 60,000 nursing residents in the U.S. with severe cognitive impairments had feeding tubes (Mitchell 2003). However, changing practice regarding the use of enteral nutrition is not accomplished merely by sharing the evidence particularly when some nurse-patient relationships have extended over years. Withdrawing enteral nutrition when used as a short term intervention for the resident who is acutely ill and there is no realized benefit in the management of the underlying acute illness, may be easier to negotiate. On the other hand, how, or if, to withdraw these interventions after their use for many years in severely cognitively impaired residents who are not acutely ill and has not articulate an advance directive, is more difficult. This presentation will describe some of the challenges faced in an 1100 bed skilled nursing facility that cares for almost 80 residents who are receiving enteral nutrition; some of our residents have received this therapy for over ten years. As part of an effort to understand the practice, chart audits and staff surveys were conducted. A case study that underscored differing professional values about the use of enteral nutrition for severely demented resident will be discussed.
Repository Posting Date:
26-Oct-2011
Date of Publication:
22-Jul-2004
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementing EBN, It’s Not as Straightforward as It Seems: Chronic enteral nutrition for persons with severe cognitive impairmentsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151661-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementing EBN, It&rsquo;s Not as Straightforward as It Seems: Chronic enteral nutrition for persons with severe cognitive impairments</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 22-24, 2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hughes, Anne M., RN, MN, FAAN</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Advanced Practice Nurse, Palliative Care</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Anne.Hughes@sfdph.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Bronwyn Gundogdu, RN; Mary McCutcheon, RN, MS</td></tr><tr><td colspan="2" class="item-abstract">In recent years, there is growing evidence questioning the use of long term enteral nutrition for persons with severe cognitive impairments such as Alzheimers&rsquo; Dementia (Finucane, et al. 1999). Enteral nutrition in this patient population has not increased survival nor decreased morbidity. In the U. S., several highly publicized cases involving the use of enteral nutrition as a life prolonging intervention for persons in persistent vegetative state (i.e. Nancy Cruzan, Terri Schiavo) have even influenced public policy. In 1999, over 60,000 nursing residents in the U.S. with severe cognitive impairments had feeding tubes (Mitchell 2003). However, changing practice regarding the use of enteral nutrition is not accomplished merely by sharing the evidence particularly when some nurse-patient relationships have extended over years. Withdrawing enteral nutrition when used as a short term intervention for the resident who is acutely ill and there is no realized benefit in the management of the underlying acute illness, may be easier to negotiate. On the other hand, how, or if, to withdraw these interventions after their use for many years in severely cognitively impaired residents who are not acutely ill and has not articulate an advance directive, is more difficult. This presentation will describe some of the challenges faced in an 1100 bed skilled nursing facility that cares for almost 80 residents who are receiving enteral nutrition; some of our residents have received this therapy for over ten years. As part of an effort to understand the practice, chart audits and staff surveys were conducted. A case study that underscored differing professional values about the use of enteral nutrition for severely demented resident will be discussed.</td></tr></table>en_GB
dc.date.available2011-10-26T11:09:30Z-
dc.date.issued2004-07-22en_GB
dc.date.accessioned2011-10-26T11:09:30Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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