Feed Me How? A study of confidence and competence related to gastrostomy care and blended diet

Project overview

This project was commissioned by the WellChild charity to Professor Jane Coad and research team at the Centre for Children and Families Applied Research (CCFAR), Coventry University. The project was undertaken in response to growing concerns that the needs of children and young people with complex care needs were rapidly rising but that carer’s competency training was not being updated or evaluated at the same rate. Furthermore, the Marmot review (2010), highlighted that little was known about confidence and competence of health professionals who deliver care and the exact nature of the training they required. Hence, there was a pressing need to robustly evaluate carer’s competencies to ensure that care was being provided by competent and confident healthcare staff so that better care at home was a reality. 

A new online Interactive Competency Framework (ICF) had been developed by David Widdas and Team (Coventry and Warwickshire Partnership Trust), for local use across the Coventry and Warwickshire Trusts for carers of children with complex care needs. David Widdas as lead had secured funding through a stream of Department of Health funding and consequently devised a number of on-line competency tools for caring for children with complex care needs. However, the competency tools called the Interactive Competency Framework (ICF) had not yet been tested or evaluated in any way and this was crucial to facilitate the further development and wider application of the tools.

The ‘Feed Me How’ project was therefore, implemented to evaluate the ICF on-line competency-based programme of learning around gastrostomy care with health professionals across the UK using a mixed methods and survey approach. It aimed to evaluate the confidence and competence of professional carers of enterally fed children and young people in palliative care. Professor Jane Coad lead a multidisciplinary team of academics (researchers, information technologists, social care practitioners) and clinicians at Coventry University to deliver and evaluate the competency training. The approach agreed by the team was to evaluate the gastrostomy needs competency package by devising project specific online survey tools presented in a user friendly e-format, to examine the knowledge, competence and confidence of professional carers before and after completing the competency training.

Professional carers had the option of completing the online training via a dedicated training website or by attending special events at Coventry University where IT facilities and support were made available. In addition, WellChild nurses were also invited and participated in the project to provide a broader perspective of complex care practices. Both quantitative and qualitative data were obtained from the surveys before and after the training in order to identify carer’s training needs and the impact the training had on their levels of competence and confidence when delivering gastrostomy care. Families were asked to complete an online survey to share their views about current gastrostomy care practices and what they felt their professional carer’s current levels of competence and confidence were. Issue around communication, confidence, competence and culture were raised.

Project objectives

The aim of this project is to pilot and evaluate an online competency based programme of learning with professional carers and families from across the UK in order to survey and report on professional carer’s skills in delivering competent and safe care to children with complex palliative needs with gastrostomy care and their families. The specific aims of the project are therefore to evaluate an online competency-based training programme around gastrostomy care by:

1. Piloting the programme on a UK sample of a) Health care professionals b) Parents and families c) Young people administering self care.
2. Developing pre and post training e-surveys to assess impact of the competency training on confidence and competency of health care professionals.
3. Hosting cascade workshops to help staff understand and embed the competency training into their practice and curriculum.
4. Evaluating the perceived short and long term impact of the competency training and supporting gastrostomy related training needs.