National Gastrostomy survey


1. Your details


2. What is the approximate number of PEGs placed at your hospital last year?


3. Who inserts the PEG's at your hospital?


4. Which indications do you insert a gastrostomy for?


5. How long would you wait after a referral before you would consider inserting a PEG?


6. At your hospital what is in place to determine who gets a PEG:


7. At your hospital do you have:


8. What percentage of PEGs referred are refused?


9. What reasons for refusal are given?


10. Do you use prophylactic antibiotics prior to PEG insertion?


11. How often is there a disagreement over whether a PEG should be inserted?


12. Have you ever felt put under pressure to perform a PEG and if so who from?


13. Is there a specific protocol in place for consent issues?


14. Do you have access in your hospital to radiologically inserted gastrostomies (RIGs)?


15. If yes are PEG insertions more common than RIG insertion in your hospital ?

Check out our survey templates or create your own.