PERCUTANEOUS FEEDING TUBE CHANGES IN LONG-TERM-CARE FACILITY PATIENTS

OBJECTIVE: To compare patient outcomes when percutaneous feeding tubes were changed routinely each month or only when necessary (prn). DESIG N: Prospective, randomized, nonblinded crossover study of 6 months of routine monthly changes compared with 6 months of prn changes. SETTING : 416-bed long-term-care facility. PATIENTS: 26 permanent residents wi th nutrition managed through percutaneous gastrostomy or jejunostomy f eeding tubes. The median age was 61.5 years; 8 (31%) also had tracheos tomies, and 3 (12%) had indwelling urinary catheters. RESULTS: The fre quency of feeding tube changes was 40 per 1,000 patient-days during th e 6 months of routine tube changes and 14 per 1,000 when tubes were ch anged prn (P<.001). There were no differences between the two study pe riods in frequency of stoma site infections, fever, episodes of emesis , and total antibiotic courses. The median duration in situ of feeding tubes with prn changes was 104 days. For both periods, feeding tubes were significantly more likely to fall out and require replacement wit hin 24 hours of previous tube replacement. CONCLUSION: There were no o bserved differences in clinical outcomes in long-term-care facility pa tients when feeding tubes were changed only as necessary as compared t o routine monthly changes.