Improving Management of Nasogastric Tubes With an Interdisciplinary Educational Intervention

Abstract

Objective: The purpose of this quality improvement initiative was to determine whether implementation of an educational intervention on medical-surgical floors could reduce the number of malfunctioning nasogastric tubes (NGTs), as well as increase nursing staff confidence in NGT management.

Design: Daily NGT assessment was done on medical-surgical floors during a 4-week baseline surveillance period. Malfunctioning NGTs were documented. Surveys were created to assess nursing staff comprehension of NGT function before and after an educational intervention. The intervention included an in-person 10-minute in-service by a senior surgical resident for nursing staff, and an "NGT Cheat Sheet" placed visibly in the rooms of patients with NGTs. Post-intervention surveillance included 4 weeks of daily NGT assessment, as well as a post-intervention survey for nursing staff. Pre- and post-intervention data was compared using Fisher's Exact Test.

Setting: Data collection, in-service education, and surveys were administered on medical-surgical floors and intermediate care units at a quaternary teaching hospital.

Participants: Nursing staff on medical-surgical floors.

Results: The educational intervention improved both nursing staff confidence in NGT management and decreased NGT malfunctions. There was a statistically significant improvement in the number of malfunctioning NGTs pre- and post-intervention, with 11/25 (44%) NGTs found to be malfunctioning pre-intervention, compared to 3/31 (10%) NGTs post-intervention (p = 0.0048). Nurses also demonstrated improved understanding of NGT function and management post-intervention.

Conclusions: This study provides evidence of a problem with NGT management that can be ameliorated with proper education. The educational intervention in this study proved to be an effective tool for closing this knowledge gap and improving NGT management. Minimizing malfunctioning NGTs may directly translate to improved patient care, and future studies are needed to assess both the short and long-term impact of this NGT educational intervention.

Keywords: gastric decompression; nasogastric tube; nurse education; quality improvement; surgical education.