Evaluating the implementation of a quality improvement initiative: Weekend gastrojejunostomy tube maintenance service in a tertiary pediatric center

摘要

Children who are unable to feed safely and adequately by mouth due to various conditions may be enterally fed via a gastrostomy (G) tube. In those children who also have gastroesophageal reflux disease, a gastrojejunostomy (GJ) tube is a frequently used option, because feedings are delivered into the jejunum via a tube that runs through the stomach into the small bowel [1,2]. Many of these children have complex multiple comorbidities. Minor maintenance problems of GJ tubes are common, such as tube leakage, dislodgement, and blockage [1,3-5], which necessitates frequent return visits to the hospital for appropriate corrective tube maintenance. Results of previous research found that return visits to the hospital for GJ tube maintenance averaged 1.2-1.7 times per year [1,3]. Although the corrective tube maintenance procedure is performed by an interventional radiologist in the interventional radiology (IR) department, most patients initially present to the emergency department (ED) to have their GJ-related problem addressed [5].