Quality statement 4: Self-management of artificial nutrition support

Quality statement

People managing their own artificial nutrition support and/or their carers are trained to manage their nutrition delivery system and monitor their wellbeing.

Rationale

People and/or their carers managing their artificial nutrition support need to be able to prevent and quickly recognise any adverse changes in their wellbeing that could be linked to their nutrition support. This includes their nutrition delivery system and storage of feed before administration. Early recognition of adverse changes enables people to obtain advice and urgent support to prevent problems arising or worsening.

Quality measure

Structure: a) Evidence of local arrangements to ensure that systems are in place for people managing their own artificial nutrition support and/or their carers to be trained to manage their nutrition delivery system and monitor their wellbeing.

b) Evidence of local arrangements to ensure that systems are in place for people managing their own artificial nutrition support and/or their carers to be able to contact a specialist urgently for advice if they identify any adverse changes in their wellbeing and in the management of their nutrition delivery system.

Process: a) The proportion of people managing their own artificial nutrition support and/or their carers who are trained to manage their nutrition delivery system and monitor their wellbeing.

Numerator - the number of people in the denominator who have received training to manage their nutrition delivery system and monitor their wellbeing.

Denominator – the number of people or the carers of people managing their own artificial nutrition support.

b) The proportion of people managing their own artificial nutrition support, and/or their carers, who are provided with contact details of a specialist in nutrition support who can provide urgent advice.

Numerator – the number of people in the denominator who are provided with contact details of a specialist in nutrition support who can provide urgent advice.

Denominator – the number of people and or the carers of people managing their own artificial nutrition support.

Outcome: a) People's confidence and competence to manage their own or others artificial nutrition support.

b) Rates of adverse events and complications in people managing their own or others' artificial nutrition support.

What the quality statement means for each audience

Service providers ensure that systems are in place for people managing their own artificial nutrition support and/or their carers to be trained to manage their nutrition delivery system and monitor their wellbeing and told how to contact a specialist to provide urgent advice and support when needed.

Health and social care professionals provide people managing their own artificial nutrition support and/or their carers with training in how to manage their nutrition delivery system and monitor their wellbeing and give them contact details of a specialist who can provide urgent advice and support if needed.

Commissioners ensure they commission services that have systems in place for people managing their own artificial nutrition support and/or their carers to be provided with training in how to manage their nutrition delivery system and monitor their wellbeing, and that provide contact details of a specialist who can provide urgent advice and support if needed.

People who are managing their own artificial nutrition support (feeding through a tube) and/or their carers are taught how to prevent, recognise and respond to any problems with their wellbeing or their artificial nutrition support system and given contact details of a specialist who can provide urgent advice and help if needed.

Source guidance

NICE clinical guideline 32 recommendation 1.5.7.

Data source

Structure: a) and b) Local data collection.

Process: a) and b) Local data collection.

Outcome: a) and b) Local data collection.

Definitions

Training

The training should ensure that a patient or carer is competent to prevent, recognise and respond to changes in their wellbeing, particularly those related to their nutritional support. They should also be competent in managing their own nutrition delivery system, including the equipment used to deliver the feed, and storing the feed in an appropriate environment.

Management

The daily self-management of a person's artificial nutritional support. Management should also include a system through which people are able to obtain urgent help from a specialist in nutritional support when needed. Self-management and/or management of artificial nutritional support by carers is not a replacement for monitoring and follow-up by care professionals. Management should be regarded as a partnership between the person and/or their carer and the care professional.

Artificial nutrition support

Enteral tube feeding and/or parenteral nutritional support.

Urgently

Urgent access to specialist advice should be available 24 hours a day every day of the week (NICE clinical guideline 32).

Equality and diversity considerations

Training and education should be accessible to people who have difficulties reading or speaking English and those who need information in non-written form.