A scoping review of clinical practices and adherence to UK national guidance related to the placement and position confirmation of adult nasogastric feeding tubes

Hamdaoui, D; Ashworth, J; Thompson, J

Abstract

The administration of nutrition or medication into the lungs or pleura via a misplaced nasogastric feeding tube is considered a never event. Despite guidance from the National Patient Safety Agency and NHS Improvement this never event is regularly reported. Confirmation of correct placement and correct use of nasogastric tubes requires appropriate actions and decisions by a multidisciplinary team. A scoping review identified 43 records that discussed and supported nasogastric tube misplacement as a Never Event. Searches were completed using Web of Science, CINAHL, Google Scholar, British Nursing Index (BNI), as well as selected journals. A further manual search revealed 22 publicly available NHS Trust policies related to nasogastric feeding tube procedures. Items generated between 2011 and 2020 were considered eligible. A thematic analysis was completed to assess adherence to guidance and the practices in place across the NHS. Three key themes were identified as part of the review: referral and authorisation of radiography, examination description, and visualisation of the nasogastric tube tip. Large variations in practice were identified. While there is recognition of national guidance, records showed inconsistency and lacked the required detail to ensure patient safety. Despite classification as a never event, it is apparent that there is still room for improvement and further guidance in ensuring patient safety with respect to nasogastric tube insertion. Practice requires further standardisation whilst also ensuring optimisation and safety. Guidance should address in depth imaging authorisation, language and exact standards of acceptability for imaging the full length of the nasogastric tube. [Abstract copyright: Crown Copyright © 2022. Published by Elsevier Ltd. All rights reserved.]

Citation

Hamdaoui, D., Ashworth, J., & Thompson, J. (2022). A scoping review of clinical practices and adherence to UK national guidance related to the placement and position confirmation of adult nasogastric feeding tubes. Radiography, 29(1), 178-183. https://doi.org/10.1016/j.radi.2022.10.032

• Journal Article Type: Article
• Acceptance Date: Oct 31, 2022
• Publication Date: Nov 28, 2022
• Deposit Date: Jan 11, 2023
• Publicly Available Date: Jan 11, 2023
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Volume: 29
• Issue: 1
• Pages: 178-183
• DOI: https://doi.org/10.1016/j.radi.2022.10.032
• Publisher URL: https://doi.org/10.1016/j.radi.2022.10.032