Authors (including presenting author) :
Li CY Michael, Yiu SM, Wong WK, Tse PW, Tseung CH, Thomas, Ma KW, Tang SW and Yeung PY
Affiliation :
Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital
Introduction :
Seeing an older family member using a feeding tube is never easy. Nasogastric (NG) tube is used in patients with dysphagia. They acquired inability to meet nutritional needs despite food modifications and owing to the possibility of aspiration. Enteral feeding allows them to receive the necessary nutrients in a safe way.
Previous study reported caregivers helping older patients receiving home enteral nutrition indicated their initial fear and refusal to administer enteral nutrition. They expressed the need for step-by-step training that begins when the patient is hospitalized and continues in the community. Besides, a systemic review on the experiences and needs of home caregivers mentioned that they have developed different coping strategies to accommodate enteral nutrition in the absence of standardized training and support.
With a mission to achieve better home care, we explored the experiences and support needs from caregivers’ perspective. With that, we remake a new set of NG tube feeding knowledge and skills video education.
Objectives :
- To develop video assisted teaching on nasogastric tube feeding.
- To assess the effectiveness of video assisted teaching on knowledge and skills development of home caregivers
Methodology :
The procedures of caring a patient with a NG tube are relatively complex. A standardized interactive program was developed to impart knowledge and skills on NG tube feeding to home caregivers. It has been used for a long term and has been proven effective. It contains a comprehensive educational booklet and clinical live demonstration by nurse. After that, caregivers will be supervised to practice tube feeding. Nurses will perform a checklist assessment of their knowledge and skills.
Beware first-time caregivers in particular, may find feeding tube management challenging. They may not be able to master the entire feeding process at once. Video was created so that caregivers could preview before attending clinical demonstration. Also, they can watch before practice or when certain parts are unclear or forgotten. In order to facilitate viewing the parts they want to refer to, we have divided the video-assisted teaching into four parts namely item preparation, medication preparation, observation (to confirm and test the feeding tube) and the feeding process and care.
Caregivers of all patients newly starting enteral feeding will receive the video education on NG tube feeding during the COVID-19 pandemic. Their performances were collected in form of a checklist. Additionally, questionnaire was designed to collect nursing professional and non-professional views on video length, depth of video content, appropriateness of video content and overall helpfulness of video.
Regarding the effectiveness of teaching videos, 57 nurses (working in medical, orthopedic wards and community nursing services), 30 student nurses and 33 caregivers completed the questionnaire.
Result & Outcome :
This is not a randomized control trial, but caregiver performance scores generally reflect that video-assisted teaching is effective for caregiver skill development.
Nurses, student nurses and caregivers had similar comments on the usefulness of this set of teaching videos on NG tube feeding knowledge and skills. The acceptance of video length, depth of video content, appropriateness of video content all exceeded 85% for all four teaching videos. Together, 98% of them agreed that all four parts of teaching video are overall useful.
Conclusion
e-learning, in form o f video-assisted teaching is effective for caregiver skill development. Improving the capacity of caregivers may help reduce complication rates and relieve caregivers stress.
This is the first theme of our enhanced caregiver support. We also produced a set of urinary catheter care video education. Likewise, our physiotherapy and occupation therapy have produced video educations on the selection and use of walking aids, holding techniques, and more. Additionally, we will insert different languages to accommodate non-native speaking caregivers. Last but not least, it is not a substitute for referral to community nursing service on discharge to home care. Caregiver can ask questions and improves their caregiving skills with input from community nurses
