Background:
Nasogastric tubes are commonly used technique to manage weight loss secondary to radiation mucositis. Historically at our institution this has been done as an inpatient. However, a previous pilot demonstrated feasibility of an ambulatory approach, which by treating 5 patients as an outpatient saved an estimated 25-50 bed days.
Method:
In order to establish an ambulatory pathway at our institution, 17 cancer centres in the UK and 1 in Ireland were informally approached as to whether they were delivering an ambulatory pathway for the insertion, initiation and ongoing management of the NG tubes.
Results:
Of the centres approached, 7 of the 18 centres offered an ambulatory pathway. This demonstrated that ambulatory feeding is achievable, being utilised across the UK. However, inpatient management remains the standard resulting in a significant bed pressure for cancer centres. Reported barriers to implementation included the provision of allied health professionals (nutrition nurses and dietetics), of an outpatient space and access to support in the community for nasogastric tubes.
Conclusion:
Ambulatory feeding is being utilised and poses an opportunity for alleviating bed pressures for cancer centres that provide head and neck cancer treatment.