dear all
a couple of weeks ago I asked for help with finding evidence on
cleaning PEG sites to prevent infection: responses are collated
below:
Carl jennings
A chat with the Stoma, Infection Control or Wound Care CNS might be
beneficial. Off the top of my head, BD is probably minimum, but PRN
would be beneficial, as is any wound care. If infected, our policy is
to use Arglaes, changed 2-3 times weekly, or whenever exudate
panetrates the dressing. In heavily exudating wounds this can be
daily.
(I have asked carl what the basis for these recommendations
are)
Gary Horrocks
suggested searching also the British Nursing Index. and EMBASE
and gave the following reference:
TI: Percutaneous endoscopic gastrostomy (PEG).
AU: White-S
SO: Nurs-Stand. 1998 Apr 1-7; 12(28): 41-5; quiz 46-7
AB: In the form of a case study that illustrates the procedure of
percutaneous endoscopic gastrostomy (PEG), this article examines the
implications of feeding patients by identifying the professional,
legal, and moral issues that are involved.
DLS and Doulas Badenoch
suggested the following Reference from
Park RHR, Allison MC, Lang J, et al. Randomised comparison of
percutaneous endoscopic gastrostomy and naso-gastric feeding in
patients with persisting neurological dysphagia. BMJ
1992;304:1406-1409.
It comes from one of our CATs:
http://cebm.jr2.ox.ac.uk/cats/gastrostomy_peg.html
Gary Horrocks
recommended searcing EMBASE and the British Nursing
Index.
and gave the following reference
TI: Percutaneous endoscopic gastrostomy (PEG).
AU: White-S
SO: Nurs-Stand. 1998 Apr 1-7; 12(28): 41-5; quiz 46-7
AB: In the form of a case study that illustrates the procedure of
percutaneous endoscopic gastrostomy (PEG), this article examines the
implications of feeding patients by identifying the professional,
legal, and moral issues that are involved.
Alison Ferguson also promised to ask colleagues in the 50 nursing
practice development units around leeds.
Peter Griffiths suggested that comparators put forward may not be
appropriate - may not need to clean at all given evidence that
cleaning often does more harm than good (Perhaps Peter should give us
a reference for that as it seems to contradict Carl's suggestion
above)
A couple of other people raised broader questions
1. Is there any evidence that PEG feeding is more effective than
manual feeding for mortality and morbidity (I point you to the CAT at
CEBM to answer that)
2. Is there any evidence that feeding proprietary brands is more
effective than liquidized 'normal' food. (I presume the fact that
the nutritional value of Hospital food is often questionable
should be taken in consideration when answering this one !)
Once again thanks for all your help will update you with 'the answer'
that they arrive at.
mark
Mark Newman
Senior Lecturer:
School of Health, Biological & Environmental Sciences (HeBES)
Middlesex University
10 Highgate Hill
London N19 5ND
Tel: 0181 362 6627 or 0181 366 6600 ex 5775
Fax: 0181 362 6299
E-Mail: [log in to unmask]
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