Evaluating caretaker satisfaction with same-day discharge after gastrostomy tube placement.

Document Type

Article

Publication Date

1-2023

Identifier

DOI: 10.1016/j.jpedsurg.2022.09.013

Abstract

BACKGROUND: Same-day discharge (SDD) after laparoscopic gastrostomy tube (G-tube) placement, using written and video-based preoperative education, has been our standard institutional practice since 2017. We aim to evaluate caretaker satisfaction with this protocol.

METHODS: All patients planned for SDD after G-tube placement from February 2021-February 2022 were identified. Chart review was performed to identify demographic information, successful same-day discharge or reason for postoperative admission, time to first postoperative feed, length of stay (LOS), and complications requiring emergency department evaluation, readmission, or reoperation. Telephone follow-up at two weeks postoperatively was conducted to evaluate satisfaction with the SDD protocol.

RESULTS: Forty-nine patients were eligible for SDD with a median age of 1.1 years [0.7, 4.4]. Forty-two (86%) patients were successfully discharged the same day with a median LOS of 7.5 h [6.7, 8.1], and 7 (14%) were admitted postoperatively for further education or emesis with a median LOS of 30.4 h [26.9, 31.2]. Median time to initiation of feeds was 2.3 h [1.7, 2.9]. 8 (16%) patients were evaluated in the emergency department within 30 days postoperatively, resulting in two re-admissions: one for peri‑stomal erythema and fever requiring oral antibiotics at 21 days and one for G-tube dislodgement requiring reoperation and replacement at 28 days. On two-week telephone follow-up, 42 caretakers (100%) felt that their education was adequate for same-day discharge and felt comfortable with the same-day discharge protocol. Six (14%) caretakers stated their child's pain was not well controlled at some point between discharge and survey follow-up, and three caretakers (7%) called a provider within the first 24 h for issues with pain. Forty-one caretakers (98%) expressed satisfaction going home the day of surgery.

CONCLUSION: Caretaker satisfaction and comfort with same-day discharge following laparoscopic G-tube placement are high, ascribed to comprehensive preoperative education and anticipatory guidance.

TYPE OF STUDY: Prognostic.

LEVEL OF EVIDENCE: Level 1.

Journal Title

Journal of pediatric surgery

Volume

58

Issue

1

First Page

70

Last Page

75

MeSH Keywords

Child; Humans; Infant; Patient Discharge; Gastrostomy; Length of Stay; Personal Satisfaction; Time Factors; Retrospective Studies; Postoperative Complications

Keywords

ERAS; Gastrostomy tube; Patient satisfaction; Patient-centered care; Same day discharge

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