Defining and evaluating the quality of care for home parenteral nutrition patients.

Home parenteral nutrition (HPN) is given to patients with long term or severe intestinal failure who cannot meet nutrition requirements by oralintake or enteral tube feeding but are able to receive therapy outside an acute care setting. These adult HPN patients have to deal with complex techniques for example connecting an infusion drip, aseptic techniquesto manage the catheters and using an infusion pump. On the other hand, they encounter psychosocial problems such as social impairment, fatigue and depression. In above, they risk dangerous complications as catheter-related infections or thrombosis, liver disease and metabolic bone disease. Therefore, these patients deserve professional and qualitative care. The global aim of this PhD project is to evaluate the qualityof care of adult patients on home parenteral nutrition (HPN). In a first step, we will identify quality indicators based on the published guidelines and expert opinion using a two-round Delphi approach. We will identify indicators for patients with a benign and with a malignant underlying disease. In a second step, we will perform a non-interventional, academic multicenter study (the CAPANAH trial which stands for CAre of patients with PArenteral Nutrition At Home) to determine quality of care in Flanders with the developed indicators. During this CAPANAH trial, we will perform semi-structured face-to-face interviews with healthcare professionals in the participating hospitals to know more in depth how currentcare is organized. In addition, we will check medication profile and adherence to those medication. In above, we will identify discrepancies inmedication profile after discharge.With the final results, we willdo a benchmarking exercise between the participating hospitals and we will identify best practices.A qualitative study will be performed to identify needs and expectations of the HPN patients discharged at the University hospital of Leuven, their home care nurse and general practitioner. We also intend to perform a European study to identify important indicators according to the patients and to compare visions across Europe.status: publishe