Practice Change for Patients with Nasogastric/Orogastric Enteral Tubes: Safety Improvement Initiative

2.50
Hdl Handle:
http://hdl.handle.net/10755/601934
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Title:
Practice Change for Patients with Nasogastric/Orogastric Enteral Tubes: Safety Improvement Initiative
Other Titles:
Clinical Therapies for the Pediatric Population [Session]
Author(s):
Irving, Sharon Y.; Crawford, Jacqueline E.; Goldberg, Elizabeth; Mohan, Anne; Ford, Nancy; Davis, Daniela H.
Lead Author STTI Affiliation:
Non-member
Author Details:
Sharon Y. Irving, RN, CRNP, FCCM, ysha@nursing.upenn.edu; Jacqueline E. Crawford, RN, CRNP; Elizabeth Goldberg, RN, CRNP; Anne Mohan, RN, NEA-BC; Nancy Ford, RN; Daniela H. Davis
Abstract:
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.
Keywords:
NG tube placement; pediatric enteral tube; feeding tube safety
Repository Posting Date:
17-Mar-2016
Date of Publication:
17-Mar-2016 ; 17-Mar-2016
Other Identifiers:
INRC15E10
Conference Date:
2015
Conference Name:
26th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
San Juan, Puerto Rico
Description:
Research Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.titlePractice Change for Patients with Nasogastric/Orogastric Enteral Tubes: Safety Improvement Initiativeen
dc.title.alternativeClinical Therapies for the Pediatric Population [Session]en
dc.contributor.authorIrving, Sharon Y.en
dc.contributor.authorCrawford, Jacqueline E.en
dc.contributor.authorGoldberg, Elizabethen
dc.contributor.authorMohan, Anneen
dc.contributor.authorFord, Nancyen
dc.contributor.authorDavis, Daniela H.en
dc.contributor.departmentNon-memberen
dc.author.detailsSharon Y. Irving, RN, CRNP, FCCM, ysha@nursing.upenn.edu; Jacqueline E. Crawford, RN, CRNP; Elizabeth Goldberg, RN, CRNP; Anne Mohan, RN, NEA-BC; Nancy Ford, RN; Daniela H. Davisen
dc.identifier.urihttp://hdl.handle.net/10755/601934-
dc.description.abstractSession 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.en
dc.subjectNG tube placementen
dc.subjectpediatric enteral tubeen
dc.subjectfeeding tube safetyen
dc.date.available2016-03-17T12:59:29Zen
dc.date.issued2016-03-17-
dc.date.issued2016-03-17en
dc.date.accessioned2016-03-17T12:59:29Zen
dc.conference.date2015en
dc.conference.name26th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationSan Juan, Puerto Ricoen
dc.descriptionResearch Congress 2015 Theme: Question Locally, Engage Regionally, Apply Globally. Held at the Puerto Rico Convention Center.en
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