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Wednesday, July 13, 2011: 2:05 PM
Learning Objective 1: The learner will be able to implement appropriate care for the patients with jejunostomy
Learning Objective 2: The learner will be able to learn more with enteral feeding with jejunostomy
Background: Jejunostomy was often constructed to provide nutrition for esophageal cancer patients with difficulties in oral intake. However, complications including diarrhea, occlusion, and skin erosion were often accompanied with jejunostomy and significantly affect the quality of life in patients. Objective: The aim of the study was to develop Taiwan clinical guideline for esophageal cancer patients with jejunostomy. Methods: Evidence-based methodologies included comprehensive systematic review, focus group with clinical experts and questionnaire survey with professionals. Results: The established guideline for jejunostomy care was constructed with 55items and was based on one clinical guideline(grade of recommendation: A), one randomized control trail(level of evidence: 2) and three relevant literatures. The guidelines comprised standards and notices of jejunostomy feeding, including feeding process assessments (22 items), monitors of complications(6 items), infection control(3 items) and prevention of tube occlusion(3 items). It also contained principles of timing, formula and rate control for initial feeding(9 items), drug administration(5 items), wound care(4 items) and documentation(3 items). Two focus groups were held to validate its cultural acceptance and meaningfulness. Ninety-eight percent of the 24 experts reached a consensus and gave suggestions on the details of practice. A questionnaire survey was conducted to assess the guideline feasibility in clinical setting. Ninety-two percent of the 240 staff nurses in the survey agreed with the guidelines. Conclusion: The study integrated literature reviews, clinical guidelines, consensus of interprofessional experts and clinical care providers to successfully establish the care guideline of Taiwan for esophageal cancer patients with jejunostomy, might provide a current best practice guideline for improving the quality of jejunostomy care delivering in Taiwan.