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Case Study: Fox Chase Cancer Center 2020 HAP Achievement Award

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Nasogastric Tube Feeding for Radiation-Induced Dysphagia in Patients with Head and Neck Cancer

As a side effect of radiation treatment, patients with head and neck cancer often have difficulty swallowing and require the temporary insertion of a feeding tube for nutrition. In its project, the cancer center evaluated whether it could improve patient outcomes by adjusting its standard of care.

Following a thorough literature review, Fox Chase’s multidisciplinary team evaluated the use of nasogastric (NG) feeding tubes against its current standard, the percutaneous gastrostomy (PEG) tube. NG tubes are threaded through the nose and into the stomach to deliver food, while PEG tubes are surgically placed through the abdominal wall into the stomach.

The center sought to achieve several goals, including:

  • Create a standardized process for inserting NG tubes and training patients and caregivers about proper use
  • Shorten the time patients need feeding tubes in an effort to return patients to a fully oral diet
  • Reduce patient pain and weight loss during treatment
  • Decrease risk for infection and long-term swallowing difficulties for patients

Through this important quality initiative, the Fox Chase team saw very encouraging results. On average, patients with NG tubes had their feeding tube in place for 29 days, compared to the 106-day average for the PEG group. Patients in the NG tube group also reported less total weight loss and less pain.

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Topics: Quality Initiatives

Revision Date: 8/1/2020

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