Nurse Practitioner-Managed Clinic Reduces Emergency Department Visits for Parents of Children With Problematic Gastrostomy Tubes. Issue 2 (April 2021)

• Record Type: Journal Article
• Authors: Maselli, Kathryn M.; Camacho, Linda; Delaplain, Patrick T.; Nguyen, Michelle V. L.; Mallicote, Michael; Philippe-Auguste, Michael; Gayer, Christopher P.
• Is Part Of: Journal of pediatric surgical nursing. Volume 10:Issue 2(2021)
• Publication Date: 2021-04
• Subjects: nurse practitioner -- gastrostomy tube -- emergency department; Pediatric nursing -- Periodicals; Children -- Surgery -- Nursing -- Periodicals; 617.980231
• DOI: 10.1097/JPS.0000000000000286
• Languages: English
• ISSNs: 2332-0249

Abstract

Abstract : Background: Gastrostomy tube (G-tube) placement is commonly performed on pediatric patients but has high rates of emergency department (ED) utilization. We hypothesized that a nurse-practitioner-driven G-tube clinic would reduce ED visits and complications and improve provider and patient satisfaction. Methods: After institutional review board approval, a retrospective chart review was conducted for all patients < 18 years old undergoing G-tube placement between January 2014 and June 2018. Data collected included demographics, indication, and type of G-tube as well as ED visits, clinic visits, and outcomes up to 1-year postoperative. Surveys were distributed to providers and parents to assess attitudes toward the clinic. Results: There was a decrease in the number of physician clinic visits, but there was no difference in overall 30- or 90-day ED visits after institution of the G-Tube Clinic. In the cohort of patients who had problematic G-tube-related problems, such as granulation, plugged tube, or tube dislodgement, creation of the G-Tube Clinic significantly reduced 30-day (0.37 vs. 0.07, p = .0008), 90-day (0.27 vs. 0.73, p = .0031), and 1-year (0.6 vs. 1.18, p = .014) ED visits. Surgeon and patient satisfaction were improved with clinic implementation. Conclusions: Implementation of a nurse-practitioner-managed clinic resulted in reduction in 30-day, 90-day, and 1-year ED visits among patients with gastrostomy issues and is associated with high levels of patient and provider satisfaction. Abstract : Supplemental digital content is available in the text.