- Your hospital dietitian will decide on the best enteral nutrition for you and will explain what you need to know.
- You will be given a supply of your enteral nutrition and all you need to enterally feed, such as syringes and any other equipment necessary to take home from hospital.
- You will be given with some simple training before you leave hospital, and the dietitian will then register your details with Nutricia Homeward.
- Once home, your Homeward Nurse will contact you to arrange a visit, where they will provide in depth training on how to care for your feeding tube at home.
- You may also be assigned a community dietitian who will review your dietetic needs accordingly.
- Nutricia Homeward will deliver everything you need on a monthly-basis (usually every 28 days) once you are home.
When you are ready to leave the hospital?
Who are Nutricia Homeward?
Nutricia Homeward are a medical nutrition company who have been contracted by the NHS to look after and help support you with your enteral feeding at home
What services do Nutricia Homeward provide?
- Nutricia Homeward Nursing Service
- Support via the Nutricia Homeward App
- Deliveries
- Stock checking
- 24 hour support
- Prescription management with your GP
Nutricia Homeward Nursing Service
Once you are home your Nutricia Homeward Nursing team will arrange to visit you in person or virtually using the Nutricia Homeward App. They will train and support you to use your pump or bolus feed, provide you with advice regarding your tube feeding and answer any questions you may have.
Your Homeward Nurse will help prevent hospital visits relating to your tube feeding by providing support at home including:
- Additional training for you, your family or anyone who supports you with your enteral feeding
- Help with any problems you may have associated with your enteral feeding
- Enteral feeding tube changes (depending on the type of tube you have)
Your Homeward Nurse
Your Homeward Nurse will provide you with a contact number. Alternatively, please call:
The Nutricia Homeward Delivery Service
- The Nutricia Homeward driver delivers your scheduled orders between Monday and Friday
- It will often be the same delivery driver each time
- If you have given Nutricia Homeward a mobile number, a message will be sent from the text ahead service. You will receive the name of the delivery driver and the details about the day and time of your delivery
- The driver may also bring the boxes into the hallway if you need them to
Nutricia Homeward deliveries may also come through DPD:
- This allows flexibility and for orders to be delivered 7 days a week
- These deliveries may be tracked online or through the DPD app
- You will receive messages about your delivery time
- Via the DPD app, you can change your delivery date or arrange for your delivery to go to a different address
- Sometimes your deliveries may come separately and occasionally things may be delivered on different days
Medical nutrition supplies
To make sure you have all you need to tube feed, regular checks will be carried out once a month. There are two ways of doing this:
By telephone
You can order you medical nutritional supplies each month by speaking to one of our patient coordinators, just make a note of what you have left and let us know and we will work out the rest. We will tailor your next delivery to ensure you don’t run out of your enteral nutrition or have more than you need.
Online
Nutricia Homeward Online is a fast and easy way to do your monthly checks at a convenient time for you. Your Homeward Nurse can help you set up your online account and offer advice on how to order your enteral nutrition.
Please visit nutriciahomeward.co.uk to register.
Nutricia Homeward app and telephone support
What is the Nutricia Homeward App?
- A quick and simple way of communicating with your Homeward Nurse
- If you have a smart phone or tablet, search “Nutricia Homeward” in Google Play or the App Store and download the app
- Your Homeward Nurse will advise you of your unique ID number and password
- Do not worry if you do not have a mobile phone, your Homeward Nurse will arrange to visit you
Our telephone out of hours service is available
24 hours a day/7 days a week
How do I get my tube feed? What happens about my prescription?
You do not need to worry about the prescriptions for your tube feed. The dietitian will liaise with your GP and a prescription will be sent to Nutricia Homeward. The dedicated prescription team has trained pharmacists at Nutricia Homeward who will process your prescriptions for you.
What about a feeding pump?
If it has been agreed that you will need a feeding pump, this will be provided by the hospital dietitian for you to take home.
A Homeward Nurse will contact you to arrange training for you, your family and anyone else who requires it.
Who do I contact if I have a question about my feeding tube or my pump?
Homeward Nurses provide high quality nursing support across the UK and will be able to answer your questions
Your Homeward Nurse will provide you with a contact number, if you don’t have this, please call
Watch this short video about the Nutricia Homeward service and how its supports a patient called Joan
- During her hospital stay Joan has been advised she now needs to be enterally fed. Joan's dietitian will register her with the Nutricia Homeward service who will support Joan’s home tube feeding needs.
Nutricia Homeward will contact Joan’s GP, organise prescriptions and set up regular deliveries of enteral feed and ancillaries to Joan at home. The Nutricia Homeward pharmacist will check the GP's prescriptions, making sure all safety precautions are met. - The Nutricia Homeward delivery will be completed by a DBS-checked, Nutricia Homeward driver or DPD partner. A text will be sent to Joan to let her know when her delivery will arrive. If necessary, the driver will carry the boxes of enteral feed into the hallway. The flexibility of Nutricia's partnership with DPD offers regular updates and flexible delivery options which is perfect for families that juggle work, life and other commitments. The Homeward Nurse will visit Joan and Tony at home to provide them with training, Nutricia Homeward information and details of the 24hr service. They will also help Joan to download and access the Nutricia Homeward App.
- Joan or Tony can contact the helpline number with any queries. A Nutricia Homeward App call can be quickly arranged to help resolve any problems. The Homeward Nurse will arrange follow up visits and continue to support Joan and Tony. Joan and Tony may complete a simple online stock check or receive a call from a Nutricia Homeward every month to make sure they have the correct amount of nutritional supplies.
- Joan’s dietitian will amend any tube feeding regime changes and has access to all nursing reports. Everyone is happy that Nutricia Homeward covers all of Joan’s tube feeding needs at home.
Office Hours
Outside of office hours, advice is available on pumps, equipment and feeding tube problems, but not on individual deliveries.
Our telephone out of hours service is available
24 hours a day/7 days a week
For everything you need to know about Nutricia Homeward, including videos, patient stories, information on your feeding pump and tube feeding equipment, as well as useful fact sheets.
| GLOSSARY OF TERMS FOR ENTERAL FEEDING | |
|---|---|
Fixation device | The piece of plastic that sits near the skin and holds your gastrostomy tube in place. |
| Bolus feeding | When your medical nutrition (such as Fortisip) is given with a syringe either by gravity or by plunging. |
| Pump feeding | When your enteral feed is given through a feeding pump. |
| Giving set | The tube connecting the enteral feed to your feeding tube via the feeding pump. |
| Extension set | Used in two possible ways: 1. Used to increase the length of your feeding tube 2. Used with a low profile device (button)- connected by turning and allows the feed to flow through |
| Two-pack connector | Used when an enteral feed and water or two packs of enteral feed need to be given at the same time through one pump. |
| Feed regime/regimen | Your enteral feeding meal plan provided by your dietitian. |
| Stoma | The hole your gastrostomy feeding tube goes through. (Not a term used for nasogastric tube). |
| Ancillaries/Ancills | Plastic equipment required for enteral feeding such as syringes, giving sets, extension sets etc. |
What is enteral feeding?
Methods of enteral feeding
Bolus feeding
Pump feeding
NB: To minimise risk of aspiration, you must be positioned at a minimum of 45 degrees whilst tube feeding; and for at least an hour after the tube feed has been discontinued.
Medications
- If you need to put any medications through your tube, the ward staff will show you how to do this before you go home
- If you take several medicines, you must only put one medication through the tube at a time with a small flush of water in between. DO NOT mix medications together
- It is very important to flush your tube with water after your last medication in order to prevent the tube from becoming blocked
If you have any questions about this, be sure to speak to the ward staff before you go home - Your Homeward Nurse will be able to support you with how to administer your medications, but your GP or Pharmacist will answer any specific queries about your medicines
A Homeward Nurse will be able to help you with your tube feeding and answer any of your questions.
Your Homeward Nurse is specially trained to provide support for people of all ages who require tube feeding and will contact you to arrange a suitable time to visit you at home.
You will be provided with in-depth training on all aspects of your tube and how to administer your enteral feed. This training can be repeated until you are fully confident.
If you have family members or carers who require training, the visit will be arranged at a time to suit everybody. If that’s not possible the training can be repeated for anyone who can't make it or would like a refresher.
What will be covered in the Homeward Nurse training?
• How to care for the skin around your stoma site or nostril
• Signs to monitor, such as possible infections
• How to care for your feeding tube at home and any specific interventions that your tube needs
• How to tube feed: either bolus feeding, pump feeding or a mixture of both
• How to administer your medications
• How to ensure your tube doesn't become blocked and what action to take if it does
• The safest position for you to be in during your enteral feed
• What action to take should your feeding tube fall out (please don't be alarmed as this is very rare)
• How to check and store your enteral feed and ancillaries (giving sets, syringes, extension sets etc.)
• Which healthcare professional to contact; this may be your dietitian, nutrition nurse and will be listed on your hospital discharge paperwork
• Anything else relevant to your enteral feeding care
• Your Homeward Nurse will answer any questions you have and provide you with any other information you need
What if I have any questions after the Homeward Nurse has left?
Office Hours
Outside of office hours, advice is available on pumps, equipment and feeding tube problems, but not on individual deliveries.
Our telephone out of hours service is available
24 hours a day/7 days a week
For everything you need to know about Nutricia Homeward, including videos, patient stories, information on your feeding pump and tube feeding equipment, as well as useful fact sheets.
Safe feeding position
It is best to sit as upright as possible when you are using your feeding tube, just like you would if sitting at the dinner table.
If you are unable to sit in this position, it is important that you sit no lower than 30 - 45°.
If you cannot sit in a position of 30 - 45° please discuss with the ward staff who will advise you what to do.
It is important that you do not lay flatter than 30 - 45° for at least one hour after feeding using your tube. This includes water flushes and taking medications.
Hygiene
Preparing, handling and storing your enteral feed
1. Handle with care
Preparing your enteral feed requires minimal handling.
2. Wash your hands
Effective hand washing must be carried out before you start preparing for enteral feed.
3. Environment
Prepare your tube feed in an environment that is as clean as possible.
4. Always read the label
Always check the best before date on your enteral feed, some products may have two dates, a best before and a production date. Check the consistency is smooth and without any curdles. Check the enteral feed is the right one for you and that the packaging is not damaged.
5. Temperature
Enteral feed and water needs to be stored at room temperature; somewhere like a kitchen cupboard or wardrobe is ideal. Do not store in a garage, fridge, near radiator’s or direct sunlight.
1. Pre-packed enteral feeds – 24 hours maximum
Ready-to-use enteral feeds may be given over a maximum period of 24 hours. Any remaining enteral feed after this time must be thrown away. If you use half a pack of enteral feed, you may store the other half in the fridge for up to 24hrs from first opening it. Remove from the fridge 30mins before using so that it returns to room temperature.
2. Re-use of opened Fortisip
If you only use half a bottle of Fortisip, the other half can be stored in a fridge for a maximum of 24hrs from when you first opened it. Remove from the fridge 30minutes before using it so that it returns to room temperature.
3. Reconstituted enteral feeds
If you are told you need to mix your enteral feed or decant it into a container, if this feed is refrigerated, the feed, the Flocare giving sets and containers are safe to reuse multiple times within a 24 hour period when refrigerated. Any remaining enteral feed after this time must be thrown away.
If you are told you need to mix your enteral feed or decant it into a container, if this feed remains at room temperature the feed, the Flocare giving sets and containers are safe to reuse within a 10 hour period, when storing at room temperature. Any remaining enteral feed after this time must be thrown away.
4. No topping-up
Never top-up enteral feeds that are mixed in a container.
Who, where and how to contact for more information?
Office Hours
Outside of office hours, advice is available on pumps, equipment and feeding tube problems, but not on individual deliveries.
Our telephone out of hours service is available
24 hours a day/7 days a week
Nutricia Homeward will contact every month to arrange your enteral nutrition product and equipment deliveries;
this can be by phone. They also request and manage prescriptions on your behalf for Homeward Pharmacy
Types of feeding tubes
| TYPES OF FEEDING TUBES | |
|---|---|
| PEG | Percutaneous Endoscopic Gastrostomy |
| BGT | Balloon Gastrostomy Tube |
| LPD | Low Profile Device (often referred to as a button) |
| NGT | Nasogastric Tube |
| NJT | Nasojejunal Tube |
| JEJ | Jejunostomy Tube |
| PEG-J | Percutaneous Endoscopic Gastrostomy with a Jejunal extension |
| BGJT | Balloon Gastrostomy Tube with a Jejunal extension |
Introduction to Flocare
Flocare Infinity pump
Cleaning instructions
- The pump is water resistant but should not be immersed fully in water
- Wipe the pump over regularly with warm soapy water or non-alcohol wet wipes
- The pump should be dried thoroughly making sure no water remains on any of the sensors which are located inside the door
Feeding Equipment and Support Guides
All products shown are foods for special medical purposes for the dietary management of disease related malnutrition
Bolus feeding
Pump feeding
We hope you have found this training useful and would like your feedback so we can make this training even better for others. Please complete our short survey.
What if I have any questions after the Homeward Nurse has left?
Office Hours
Outside of office hours, advice is available on pumps, equipment and feeding tube problems, but not on individual deliveries.
Our telephone out of hours service is available
24 hours a day/7 days a week
For everything you need to know about Nutricia Homeward, including videos, patient stories,
information on your feeding pump and tube feeding equipment, and useful fact sheets