Ashby ward is a neurorehabilitation unit at Lincoln Hospital. A significant number of our patients have balloon gastrostomy feeding tubes to meet their nutritional and fluid needs (and to get medications) as they are unable to take these by mouth.
Problem
If these balloon gastrostomy tubes come out then the tract can close quickly and there is no route for providing nutrition, fluid or medications. If the tract completely closes then a new tube needs to be placed, which is an invasive procedure.
A couple of times these balloon gastrostomy tubes have fallen out outside of office hours and nursing staff have had to insert a catheter into the tract to maintain this (cannot be used) and place a nasogastric tube for feeding, fluid and medication under the guidance of an on call doctor. Then a balloon gastrostomy would be replaced within working hours. This is not the best practice for the patient and increases the potential discomfort and intervention.
Action
Training with all ward doctors and nurses on Ashby ward so that they can replace balloon gastrostomy tubes if they come out.
A replacement gastrostomy kit is in place on the ward, which is restocked efficiently by the ward clerk
Outcome
Ashby ward nurses have successfully replaced 3 dislodged balloon gastrostomy tubes since the training. This has given our ward staff an advanced clinical skill which allows them to provide the full complement of care this patient group and vastly improve patient experience.
Well done to the Ashby ward team!