Lacey, D. (2005). Tube feeding, antibiotics, and hospitalization of nursing home residents with end-stage dementia: Perceptions of key medical decision-makers.
Retrieved 24 October, 2011 from http://aja.sagepub.com/content/20/4/211.abstract
The paper by Lacey describes the major challenges to the use of tube feeding including PEGT in neurological patients. The paper was based on selective evaluation of health care giver at 138 nursing homes that make use of tube feeding in relation neurological patients. Lacey also discussed the views of the health care giver at those nursing homes in relations to providing quality tube feeding as a form of palliative care. Findings by the research indicated that most would support provision of the tube feeding, as palliative measure but that must be done after obtaining high quality education as regards to managing such patients with dementia.
Lacey shows that there is different perception among the social service staffs when compared with the nursing staffs and medical directors. She ensured that the focus of the paper were not lost but ensured that the importance of quality as regards to administration of the palliative measures was fully considered.
Lynne, M. & Lipmann, T., (2003). Percutaneous Endoscopic Gastrostomy Does Not Prolong Survival in Patients With Dementia.
Retrieved 24 October, 2011 from http://archinte.ama-assn.org/cgi/content/full/163/11/1351?linkType=FULL&resid=163/11/1351&journalCode=archinte
The article presented by Lynne and Lipmann focused majorly on the issue of associated life prolongation in-patient fed with feeding tubes such as percutaneous endoscopic gastrostomy. The paper highlighted some of the previous research that shows no conclusion as regards to life prolongation benefit with PEG form of feeding. The approach or methods used by the researchers were to consider all forms of consultation as regards to the PEG tubes placement and management. Results of those that received the tubes and those that refused the tube usage were compared. The result of the research though conducted on small sample size shows no major differences between the two groups of patients as regards to their survival rate.
The paper did not actually provide any related QSEN competencies requirements in those nurses that are involved in the care for such patient. This might have been a factor in the outcome considering the effects of management expertise in those nursing homes where nurses care for the patients with dementia and dysphagia
Loser et al, (2005). ESPEN guidelines on artiﬁcial enteral nutrition—Percutaneous endoscopic gastrostomy.
Retrieved 24 October, 2011 from http://www.espen.org/documents/PEG.pdf
The article provides changes the clinicians have instituted over time regarding the management of patient with the use of PEG feeding. Modifying and implementing the guidelines as they are being provided is another consideration of the paper. The authors commented on the various ethical issues around the use of PEG feeding in the nursing home. Clinical values and quality of life with those patients such as energy provision and nutritional support were outlined and the recent developments in the management were considered.
Compared with the other reviewed articles, the authors focus more on careful patient selection for nursing home use of PEG. The paper also considered the age of the patient receiving the type of feeding as a major factor for determinant of outcome. The patients’ selection factors and acceptance were also considered by the author as main consideration in the guideline for management of patients with PEG tubes.