Development of an ‘Enteral tube feeding decision support tool’ for hip fracture patients: a modified Delphi approach

Objectives: Malnutrition after hip fracture is recognised as the co-morbidity most likely to impact hospital length of stay and cost. Despite this, the role of enteral tube feeding in hip fracture patients remains unclear. Methods: A modified Delphi process was used to establish consensus for an enteral tube feeding decision support tool. Three rounds of the Delphi survey were administered to a purposeful sample of twenty multidisciplinary clinicians from the Australian and New Zealand Hip Fracture Registry. Results: Consensus markedly improved across the three rounds (33, 44 and 87%, respectively). More than 80% of participants positively supported implementing the tool in clinical practice. Conclusions: This study describes experienced, multidisciplinary clinician consensus and support for an ‘Enteral tube feeding decision support tool’ to be applied in acute hip fracture settings. Further studies are being undertaken to identify the impact of the checklist tool on informed consent decision processes in this population.