Dr Flora Kokwaro

SpR Trainee Audit/Quality Improvement Award

“My Tube Passport – Mind My Tube.” A hospital e-passport for the patient with an enterostomy device.

Patients with enteral tubes may visit multiple hospitals with complications such as blockages or displacements or other non-tube related medical conditions that require the use of their enteral tubes. However, knowledge of enteral tubes amongst health care staff can vary and is often dependent on speciality and experience and this can impact on their ability to readily identify and solve issues.

As a further challenge, the paper patient passports currently used, can easily get mislaid by the patient or carer. Dr Kokwaro believes that ensuring that all the relevant information is available in electronic rather than paper form has the potential to benefit these patients not least by providing HCPs with key information to manage complications in a timely fashion. This would hopefully result in minimizing interruptions to nutrition and medications delivered by enteral tubes, reduce the length and number of hospital admissions and generally improve patient quality of life by reducing anxiety and stress.

The aim of the project was therefore to develop an user friendly, accessible and adaptable electronic passport in form of an app. Initially we gathered the view of patients on the challenges they faced when they attended hospital, followed by an online survey of HCPs who might deal with enteral tubes. This information
was analysed and an outline design for the app created. They are now currently looking to develop this into a functioning app.

“Not only am I overjoyed that there is an opportunity to contribute to improving patients’ quality of life in this aspect of intestinal rehabilitation and nutrition, but I hope this will grow on to be a sustainable contribution adaptable to other aspects of nutrition.”

Why did you choose this project?

‘Two years ago, as a GI trainee, I reviewed a young patient who had presented with a displaced feeding tube. The mother told me of her challenges and frustrations when things went wrong with the tube: delays caused by misplaced information, missed feeds and the distress caused by needing intravenous medication as a stop gap. I was very moved by her story and really wanted to
help. To have a chance to contribute to improving quality of care in a patient’s life is truly one of the most gratifying aspects of medicine. Thanks to this award, the silent promise I made 2 years ago to improve the ‘away from home’ experience
of patients with enteral tubes can now become a reality.”