Home enteral nutrition NICE guidelines and nutrition support in primary care.

The Home Enteral Nutrition team provides support to patients who are being fed via enteral feeding tube in the community. The use of the recently developed policy in combination with the National Institute for Clinical Excellence (NICE) guideline on nutrition support will change the way care is provided to patients and enhance service delivery. However, there are difficulties in the implementation of policies and guidelines which often militate against the delivery of high standard of care. This paper was an attempt to apply the Kotter's eight-step change management model in the implementation of the HEN team policy and NICE guideline on nutrition support through training of district nurses, liaison with colleagues and carrying out a clinical audit. The clinical audit was aimed at institutionalizing the new approach for the delivery of quality care. The Kotter's model recognized the urgency needed and it enabled the building of coalitions that is essential in meeting the desired standard in today's NHS.