Quality Improvement Initiative: The Administration of Early Nutrition Following Percutaneous Endoscopic Gastrostomy Tube Placement in Children

It is common practice for providers to wait up to 24 hours to begin enteral feedings using a newly placed gastrostomy tube in children. As a quality improvement initiative, guidelines were developed to begin early enteral nutrition 4 hours following gastrostomy tube placement. These patient care guidelines standardized electronic ordering, dosing, and feeding administration instructions. Healthcare professionals from the departments of gastroenterology, case management, and nutrition were asked to evaluate the new process by completing a questionnaire. Changes were made to the quality improvement initiative on the basis of the feedback received from the questionnaires. The early feeding initiative aimed to improve patient outcomes and enhance the quality of care received following the child's gastrostomy procedure. These guidelines will then be used in a prospective clinical trial to evaluate the validity of the quality improvement initiative.