Journal of Molecular Imaging & Dynamics
Open Access
ISSN: 2155-9937
ISSN: 2155-9937
Shubra Kochar
Registrar at South Tyneside and Sunderland NHS Foundation Trust, UK
Scientific Tracks Abstracts: J Mol Imag Dynamic
Background: Nasogastric tube feeding is common practice and thousands of tubes are inserted daily without incident. Feeding into the lung, through a misplaced nasogastric tube is now a "Never Event" in England. "Never Event" reports to National Patient Safety Agency (NPSA) suggests there are issues with X-ray interpretation. This audit assesses the documentation required after second line X-ray confirmation of tube placement following initial insertion prior to commencement of usage for feeding. Audit compliance with NPSA patient safety alert:2011/PSA002 - reducing harm caused by misplaced nasogastric tubes . Retrospective baseline data looking at 50 case notes for all the patients who had chest X-rays performed to establish position of nasogastric tube for the purpose of feeding across Sunderland Royal hospital were randomly identified and scrutinised against the NPSA and local guidelines with a target of 100%.A four -point quality of guidelines score showed that, only 22% were able to document the whole four points, 66% documented it partially and 12% did not document the four points at all. 90% of the radiologists’ included tube and tip position in their reports and 68% reports made appropriate comments on use of feeding. Audit findings and results were published in monthly trust bulletin. Nursing staff, Doctors and Practitioners requesting second line X-ray confirmation of nasogastric tube placement were reminded to ensure accurate documentation prior to utilisation of nasogastric tube for feeding, information poster with guidelines were stuck in doctor’s and nursing station. Re-audit was established in 5 months of implementing changes. Reaudit established that 37/50 (74 %) cases had all four-points documented appropriately but still 26% documented it partially and again 90 % radiologists included tube, tip position in their report and 90 % reports made appropriate comments on use of feeding. It is hoped that there could be a roll out of the intervention hospital-wide with identification of further ways to improve documentation of NG tube in patients’ notes before safe feeding.
Shubra Kochar, Registrar at South Tyneside and Sunderland NHS Foundation Trust, UK.