Training healthcare professionals in PEG (Percutaneous Endoscopic Gastrostomy) feeding is vital to ensure patient safety, effective nutritional management, and infection control.

Proper understanding and skills help prevent complications, enable professionals to educate patients and families, and ensure ethical and psychological considerations are addressed.

What is a PEG Feed?

A percutaneous endoscopic gastrostomy (PEG) is a method of enteral tube feeding where nutrients, fluids, and medicines are delivered directly into the stomach by passing a thin tube through the skin and into the stomach. It is usually required when someone has trouble swallowing, meaning that they do not get enough nutrients by mouth. It may also be used when a person has issues with their appetite or is at risk of aspirating food taken by mouth.

Unlike a nasogastric feeding tube (which is passed through the nasal cavity), a PEG feeding tube is designed for long-term use and can last for several months or sometimes years before it needs to be replaced. However, PEG tubes may become clogged or break over time, in which case they may need to be replaced early.

Why Does a Person Need a PEG?

A PEG feeding tube is usually required when a person has difficulty swallowing. There may be a number of reasons for this including, for example:

Stroke
Cancer
Surgery
Traumatic Brain Injury
Central Nervous System Disorders

A PEG device may also be a solution for someone who has burns to their face or throat, or who has other injuries that would prevent them from swallowing. Another reason a person may need a PEG is if they are going to be unconscious for an extended period - for example, if they are in a coma (either medically induced or resulting from an accident). PEG feeding is also sometimes used to ‘top up’ a person’s nutrition if they still have the ability to eat, but cannot eat enough to provide all the nutrients or fluids that they need.

A PEG may be a temporary solution to feeding difficulties such as during cancer treatment; however, in some instances and especially in degenerative neurological conditions such as motor neurone disease, Parkinson’s disease, multiple sclerosis or stroke, a PEG can be a longer term or permanent feeding method.

What Healthcare Professionals Are Needed to Fit and Care for a PEG Feeding Patient?

An endoscopy nurse will be present to help the individual with the preparation for the procedure. They will also help the surgeon during the fitting of the PEG tube.

A nutrition nurse may help with post procedure, including explaining aftercare and how to use the PEG tube appropriately. They are also tasked with keeping ward staff up to date with current feeding techniques.

Ward nurses attend to the individual before they leave the hospital.

A dietitian will help with feeding and nutritional information, including feeding schedules, techniques, and aftercare of the equipment. They are usually the main point of contact once the person leaves the hospital.

Healthcare Team in the Community

People in the community using a PEG for feeding should be supported by a wider multidisciplinary team including dietitians, district, care home or homecare company nurses, GPs, community pharmacists and, where appropriate, other allied healthcare professionals such as speech and language therapists.

An Introduction on How to PEG Feed

Methods of Tube Feeding

There are 3 main methods for feeding a patient using a PEG tube:

gravity feeding
bolus feeding
pump feeding.

The method of feeding to be used will be determined by the person’s healthcare team and will be detailed in their care plan.

For more information on how to feed a patient using a PEG tube, get in touch to find out how to register for Blue Stream Academy’s PEG feeding training for carers, support workers and healthcare professionals.

Care of the Feeding Tube and Stoma Site

The point at which the tube exits the abdomen is called the stoma site. The stoma site must be cleaned and managed appropriately to avoid complications. The care process includes cleaning, rotating, drying, checking for infection and checking the tube.

The full cleaning and management process is covered in our PEG healthcare eLearning module.

Is PEG Feeding Reversible?

Yes, PEG (Percutaneous Endoscopic Gastrostomy) feeding is generally reversible. PEG feeding involves the placement of a tube directly into the stomach through the abdominal wall, which is used for long-term nutritional support in individuals who are unable to eat by mouth. The tube can be removed when it's no longer needed, provided the patient's condition allows them to safely resume oral intake or switch to another form of nutritional support. The site where the tube was inserted will typically heal on its own, but it may leave a small scar.

PEG Feeding Training Courses

Blue Stream Academy provides online PEG Feeding training aimed towards those who have received practical instruction on using enteral devices which have been fitted through a gastrostomy or jejunostomy procedure. The course includes information to refresh the learner’s skills and knowledge on standard procedures for enteral feeding and aftercare. Our PEG Feeding healthcare training programme is available on:

the GP eLearning and Management platform
the Health and Social Care eLearning and Management platform
the Hospice eLearning and Management platform
and the Private and Urgent Care eLearning and Management platform.

Some people who use a PEG device are able to perform feeds and care for their PEG equipment unaided, whereas others may need assistance - our module aims to provide guidance to healthcare professionals on how to either assist someone with using a PEG feeding tube or performing feeds for someone if they are unable to do this themselves. Our PEG Feeding course has been designed as a health and social care training course, suitable for a range of healthcare professionals including a variety of roles such as registered nurses.

An Introduction to PEG Feeding for Healthcare Professionals