Practice change for patients with nasogastric/orogastric enteral tubes: Safety improvement initiative
Sharon Y. Irving, RN, CRN FCCM; Jacqueline E. Crawford, RN, CRN; Elizabeth Goldberg, RN, CRN; Anne Mohan, RN, NEA-BC; Nancy Ford, RN; Daniela H. Davis
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Irving, Sharon Y. by View
Popular Works for Irving, Sharon Y. by Download
Session presented on Saturday, July 25, 2015:
Purpose: The safety of bedside insertion for NG/OG tubes has become of increasing concern, particularly in pediatric patients. Serious safety events involving the misplacement of NG/OG enteral tubes prompted a review of our existing practices by a multidisciplinary team. The focus of the review was to assess existing practice and its alignment with the current literature and best evidence on the topic of NG/OG tube placement. The purpose of this project was to 1) educate multidisciplinary patient care staff to the risks associated with NG/OG tube insertion; 2) revise practice to align with current best evidence regarding NG/OG tube placement; 3) increase patient safety during NG/OG tube insertion through increased monitoring and ongoing patient assessment.
Methods: To accomplish the goals of improved patient safety while aligning practice with current best evidence, a multidisciplinary team consisting of advance practice nurses, the medical patient safety officer, and nursing leadership took on the following tasks: 1) reviewed the current pertinent literature related to NG/OG tube placement verification; 2) benchmarked our institution with other tertiary care pediatric hospitals of similar size and patient populations; 3) incorporated the expert opinions of advanced practice nurses, bedside clinical nurses, and physicians familiar with the literature and with the clinical challenges of NG/OG tube placement; 4) engaged in small group discussions and education sessions with multidisciplinary groups throughout the institution on proposed practice changes; 5) identified a sub-group of patients at increased risk for tube misplacement, with recommendations on verification of NG/OG tube placement in this group; and 6) revised the order panel in the electronic medical record for NG/OG tube insertion to align with the practice changes. The coordinating team developed a stepwise approach to the procedure using a problem-solving algorithm to guide patient assessment during NG/OG tube placement. An electronic learning module was created pertinent to all clinical patient care providers, and standardized documentation was developed for the procedure.
Results: Following a comprehensive examination of current practice throughout our institution and an extensive literature review, changes were made in May 2014 to the procedures and standard of practice for NG/OG tube placement. The changes have been adopted hospital-wide for all in-patient and perioperative areas, inclusive of intensive care units. Quarterly checks are ongoing to determine impact and adherence to the new practice changes.
Conclusion: Education to all patient care providers using current best evidence resulted in changes to the current practice of NG/OG tube placement and movement of the procedure to the domain of multidisciplinary patient care rather than solely nursing care. A multidisciplinary collaborative team with input from many stakeholders for this procedure resulted in changes to the practice and standards for NG/OG tube placement to enhance patient safety during the procedure.
Research Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.
|Review Type||Abstract Review Only: Reviewed by Event Host|
|Keywords||NG Tube Placement;
Pediatric Enteral Tube;
Feeding Tube Safety
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subjects.
Verification methods of nasogastric and orogastric tubes: Improved patient outcomes through nurse adherence to practice guidelines Kaple, Jennifer M. (2017-01-09)Although there are various methods that are used to confirm the placement of nasogastric (NG) and orogastric (OG) tubes prior to the administration of any substance, there is none that is used universally and with certainty ...
Brown, Ann-MarieMore than 30% of children admitted to the Pediatric Intensive Care Unit (PICU) are malnourished and are at risk to develop new or worsened malnutrition during their hospitalization. Delivery of enteral nutrition (EN) during ...
Comparison of nurse versus ordering provider perceived barriers to anthropometry measurements in critically ill children Irving, Sharon Y.; Mascarenhas, Maria R.; Srinivasan, Vijay; Seiple, Stephanie; Perkel, Madeline Masucci; Falk, Shiela E.; Nagle, Monica L. (2013-12-19)Session presented on: Tuesday, November 19, 2013: Methods: IRB-approved online survey using six intraprofessional list serves. Characteristics of the care environment, provider, and perceived barriers to anthropometric ...
Continuous versus intermittent nasogastric feeding for patients on mechanical ventilation: Impacts on gastric emptying and pulmonary aspiration-A comprehensive systematic review Huang, Yi-Jen; Yang, Chi-Hsuan Asphodel (2012-01-04)(41st Biennial Convention) Every 100 patients receiving mechanical ventilation, 6-25 of them will acquire ventilator associated pneumonia. Nasogastric tube (NG) feeding is usually administered to patients on ventilator for ...
Decker, Roxy Lee; Black, Andrea Elizabeth (2016-03-21)Session presented on Monday, November 9, 2015 and Tuesday, November 10, 2015: The ongoing verification of Nasogastric Tube location presents a challenging clinical dilemma and the risk to the patient of incorrect placement ...