AIF Questionnaire Acute Intestinal Failure Special Interest Group
Date Name Title Address Dear Sir / Madam Re: European survey of high output enterocutaneous fistula management
The European Society of Parenteral and Enteral Nutrition (ESPEN) has a special interest group which wishes to optimise both the provision and management of acute intestinal failure in Europe. The first step in this goal is to develop a network of the hospitals and teams that have developed an interest in treating this condition. We appreciate that there are many different calls on your time, but we hope that you will be able to complete the attached 2 page questionnaire and return to the address below. By participating in this survey you can become part of a European clinical network for acute intestinal failure. Such a network will enable shared protocols as well as research and educational programs. You have received this questionnaire as it has been suggested that you manage patients with high output enterocutaneous fistulae. In particular, we wish to gather information on some of the differences in the facilities and management of patients with high output enterocutaneous fistulae resulting in intestinal failure. We know already that different countries have very different healthcare structures and this is likely to result in differences in patient types as well as different management approaches. If you have received this by email then you will have received 2 versions: a PDF and a word document. If you wish to print it out then the PDF is the most reliable. This can then be completed and then scanned and emailed / faxed / posted. If it is easier for you to complete on the computer then open the word document and save on your computer. This can then be emailed back to us. We plan to present the results of this questionnaire at the next ESPEN Congress in Barcelona in September 2012. We can assure you that all published results will be anonymised and, if required, the results can be sent out to you directly. Thank you for taking the time to complete this survey. Please return to: Dr Simon Gabe Dr Jon Shaffer
Yours sincerely Simon Gabe and Jon Shaffer On behalf of the ESPEN Acute Intestinal Failure Special Interest Group
A European survey to assess the management of patients with high output enterocutaneous fistulae ESPEN Acute Intestinal Failure SIG About your hospital
Discipline (eg nurse, dietitian, pharmacist)
About your centre / unit Do you care for patients with a high output enterocutaneous fistula?
Do you accept referrals from other centres? Yes / No
- combined medical and surgical ward - dedicated intestinal failure unit
Do you have a multidisciplinary nutrition team? What population do you receive patients from? Local Regional National Aetiology of enterocutaneous fistulae Do you have a database relating to these patients? For your current inpatients, how many have the following conditions resulting in the development of enterocutaneous fistulae? Management of enterocutaneous fistulae What do you consider to be a meaningful high output fistula? In patients with a newly developed enterocutaneous fistula
a) Do you have a policy which includes fluid & food restriction?
b) At what point in time do you allow a patient to:
In patients with a non-spontaneously healing enterocutaneous fistula
a) Do you have a policy which includes fluid & food restriction?
b) At what point in time do you allow a patient to:
In patients with a high output fistula, do you use? Do you ever try to feed patients distally? (If yes, how many patients over the past year?) How many enterocutaneous fistula resections / repairs have been performed in the past 12 months in your unit? In a patient with an enterocutaneous fistula:
a) Do you have a policy on when to operate?
_____ weeks / months (delete as appropriate)
Send the patient back to the referring hospital
d) Does the timing of surgery depend on the cause
Do you have the expertise in your centre to manage these patients on home parenteral nutrition until surgery can be performed? In the past 12 months have you used any of the following in the surgical treatment of enterocutaneous fistulae?
a) Abdominal wall meshes to close the abdomen?
b) Component separation to close the abdomen
Training & outcomes Do you and your multidisciplinary team feel that you have had appropriate training in management of patients with a high output enterocutaneous fistula? What is the re-fistulation rate in your unit after corrective surgery in the past year? How many of your current inpatients have a recurrent fistula? Finances 17 Do the current coding systems in your country account for the complexity of the surgery performed in these patients? 18 Is there appropriate financial remuneration for the care of these patients:
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