Improving patient safety by reducing the number of chest x-rays required to confirm Nasogastric (NG) position

Innovative work undertaken in the University Hospital of Wales to reduce the number of unnecessary chest x-rays performed to confirm NG tube position.

Joint collaboration between Radiology and the Nutrition Support Team supported by the Continuous Service Improvement Team.

During working hours, the Nutrition Nurse Specialist (NNS) would be bleeped to attend the ward and undertake an assessment of the NG tube, when a request for x-ray to confirm position was received by the Radiographer.

Bedside education regarding correct placement of NG tube and methods to successfully gain aspirate would be given to the practitioner who inserted the NG tube. If aspirate was gained and pH5.5 or below, the x-ray request would be withdrawn.

The patient would not undergo an unnecessary procedure, reducing their exposure to radiation and feeding delays would be prevented.

During three audit cycles 54% to 71% of chest x-rays have been cancelled.

The poster can be viewed here https://www.dropbox.com/sh/tk0pdwb5xrhkoiy/AAB4v199S4BGdYoykwIex-nma?dl=0

The full research findings can be found in Complete Nutrition: Vol.14 No.6 Dec 2014/Jan 2015 Nasogastric Feeding Tubes – A service improvement project to reduce the number of unnecessary chest x-rays.

The team also won Nutrition Nurse of the Year from the BJN based on this work

For further information contact :

[email protected] or [email protected]

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