Development of a clinical practice guideline for testing nasogastric tube placement

Abstract

Purpose: A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the "whoosh test" and litmus paper, and introduction of pH testing.

Design and methods: Two audits were conducted: bedside data collection at a pediatric hospital and a point-prevalence audit across seven hospitals.

Results: Aspirate was obtained for 97% of all tests and pH was < or = 5.5 for 84%, validating the practice changes. However, patients on continuous feeds and/or receiving acid-inhibiting medications had multiple pH testing fails.

Practice implications: Nasogastric tube placement continues to present a challenge for those high-risk patients on continuous feeds and/or receiving acid-inhibiting medications.