The Feasibility Study of a Revised Standard Care Procedure on the Capacity of Nasogastric Tube Placement Verification Among Critical Care Nurses

Feng-Huang YANG ； Feng-Yu LIN ； Yueh-Juen HWU

《The Journal of Nursing Research》 27卷4期 (2019/08) Pp. 1-8-003

https://doi.org/10.1097/jnr.0000000000000302

摘要

Background: Evidence-based studies propose that the aspirate pH test may be easily and reliably conducted to verify the proper placement of nasogastric tubes (NGTs). Nurses rarely implement this procedure because of the lack of related knowledge. Purpose: The purpose of this study was to explore the feasibility of implementing a revised standard care procedure to enhance nurses' ability to verify placement of the NGT. Methods: his study used a quasi-experimental, longitudinal research design. Nurses from two intensive care units were randomly assigned to the experimental group (n = 35) and the control group (n = 31). A revised standard-of-care procedure to confirm the proper placement of an NGT was incorporated into a slideshow presentation, a printed leaflet, and an audit checklist. The experimental group received continuous education and individual teaching on the revised standard-of-care procedure, whereas the control group did not receive additional education and continued to provide conventional care. The study gathered data using scales designed to address knowledge of and attitudes toward verification of NGT placement and the checklist for auditing the NGT care procedure. Scales were implemented before and after the practice program was conducted, in Months 1, 2, and 3, to evaluate the feasibility of the developed improvement measures. Results: This study found significant improvements in the experimental group in terms of knowledge regarding NGT placement verification and the NGT care auditing procedure. The positive improvement of the intervention on the NGT care auditing procedure remained for at least 3 months after the end of the intervention. Conclusions: The findings suggest that using an aspirate pH test is a feasible approach to verify NGT placement in critical care units, a crucial aspect of care necessary to promote patient safety and quality of care.

關鍵字

critical care ； intervention study ； nasogastric tube ； placement verification

參考文獻

Ke, S. C., Lin, F. Y., Hsieh, Y. H., Hwu, Y. J., & Chang, C. N. (2014). Project to increase the nasogastric tube verification practice. Show Chwan Medical Journal, 13(3–4), 63–72. https://doi.org/10.3966/156104972014121303002 (Original work published in Chinese)

Lin, Y. L., Liao, C. C., Yu, W. P., Chu, T. L., & Ho, L. H. (2018). A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. The Journal of Nursing Research, 26(4), 288–296. https://doi.org/10.1097/jnr.0000000000000251

American Association of Critical-Care Nurses. (2016). AACN practice alert: Initial and ongoing verification of feeding tube placement in adults. Critical Care Nurse, 36(2), e8–e13. https://doi.org/10.4037/ccn2016141

Boeykens, K., Steeman, E., & Duysburgh, I. (2014). Reliability of pH measurement and the auscultatorymethod to confirm the position of a nasogastric tube. International Journal of Nursing Studies, 51(11), 1427–1433. https://doi.org/10.1016/j.ijnurstu.2014.03.004

Bourgault, A. M., Heath, J., Hooper, V., Sole, M. L., Waller, J. L., & Nesmith, E. G. (2014). Factors influencing critical care nurses' adoption of the AACN practice alert on verification of feeding tube placement. American Journal of Critical Care, 23(2), 134–143. https://doi.org/10.4037/ajcc2014558