Thoughts RE Inter-facility communication

[Guest guest]

One of the ASPEN guidelines for choosing a Home Enteral Provider (often a DME:

Durable Medical Equipment company) is the presence of clinical staff.

Unfortunately, there are many DMEs that do not employ or contract with RDs. It

is my observation that some case management depts. are not aware that some DMEs

have no clinical staff (RD, RN, Pharmacists, etc). It is my hope that acute

care/SNF RDs steer their case management colleagues to work with DME companies

that employ RDs.

Here is a summary of some home care situations I have encountered when we (a DME

in Chicago) set up patients who were previously with DMEs sans RD support:

Enteral pump still in a box, DME did not instruct on equipment operation

Patients drinking formula formulated for enteral not oral consumption, adding

chocolate sauce

Patients not aware of flush orders

24 hr of formula hanging in an open system

Caregivers crushing meds together and adding to formula

Unhealthy GT sites, that needed RN evals

Patients using one syringe for months, and months

Mother adding thickener to formula (2 weeks old infant), and run this through 5

FR NGT

Formula supply not rotated, and not stored in a clean area (by a cat litter box)

My second patient advocate request......... as an RD in home care, I find

acute/SNF RD notes extremely valuable. At many facilities the RD note is not

sent, unless specifically requested. While DME companies have HIPPA rights to a

patient's complete medical record, we receive less and less information, and

waiting longer and longer for medical records. When there is a liaison on the

case, the info flows best, but this is not always the case. I would hope that RD

notes are routinely sent with D/C orders to the health professionals monitoring

your patients.

Thank you.

Osowski

Enteral Nutrition Program Manager

Quality Healthcare

Arlington Heights, IL

Shorewood, IL

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