Abstract

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 of safety. Unreliable and contradictory methods for confirming tube placement ultimately leads to misplaced tubes and causes considerable adverse events including pneumonia, lung collapse, and fatality. In adult patients within a northcentral Ohio community hospital, greater than 18 years of age, requiring the placement of an NG or OG feeding tube [P], how does implementation of a systems-wide approach to update adherence guidelines for the most reliable NG and OG tube verification practices prior to the administration of tube feedings, medications, or H2O boluses based on EBP literature [I] compare to the current practice [C] in increasing adherence of updated practice guidelines, increasing the identification of misplaced NG and OG tubes, and decreasing adverse events to patients [O] over a three-month time frame [T]? Evidence suggests that auscultation of air bolus, visual inspection of gastric aspirate, water bubbling, litmus paper, ultrasonography, capnography/capnometry, bilirubin testing, and enzyme testing are unreliable methods to utilize for verification of initial NG and OG tube placement; while, pH measurement of gastric aspirate ≤/= 5.5 is a reliable method and radiographic confirmation remains the gold standard. The Johns Hopkins Nursing Evidence-Based Practice Model was utilized to guide the development and implementation of this evidence-based practice project.

Author Details

Jennifer M. Kaple, DNP, BSN, RN

Sigma Membership

Unknown

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Clinical Practice Guideline(s)

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Nasogastric Tube, Orogastric Tube, Feeding Tube Placement, Adherence/Compliance, Verification Methods, Feeding Tube Safety, Practice Guidelines Standards

Advisor

Huey-Shys Chen

Second Advisor

Susan Sochacki

Third Advisor

Martha Sexton

Degree

DNP

Degree Grantor

The University of Toledo

Degree Year

2016

Rights Holder

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.

Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2017-01-09

Full Text of Presentation

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