IMPLEMENTATION OF MULTIDISCIPLINARY NASOGASTRIC TUBE REMOVAL PROGRAM IN HOSPITAL

Abstract

Background

Prolonged nasogastric tube (NG tube) use may cause physical and psychological discomfort, and increase the risk of various complications, such as mucosa damage, tube loosening, gastric reflux, etc. These adverse events not only have negative effects on patient’s well-being and life quality, also increase caregiver burden and associated healthcare costs. Our team discovered the low NG tube removal rate in the rehabilitation ward, while there was no clinically available standardized protocol. Hence, the aims of this study were to established a NG tube removal program and assessed the feasibility.  

Methods

Nasogastric tube removal program was implemented by a multidisciplinary team, including physiatrists, nurses, speech and language therapists and nutritionists. The standardized training protocol for removal of nasogastric tube was designed and established by the team, and carried out in the rehabilitation ward of Shuang Ho Hospital from January to December in 2022. Lessons were given by experienced team members to ensure the NG tube caring quality provided by clinical staffs and the ability to evaluate for removal of NG tube. The primary outcome was the rate of successful NG tube removal before discharge, which was defined as no complication or any event of reinsertion within 3 months. The secondary outcome was the rate of patients who transferred from tube feeding to oral intake successfully at discharge.

Results

101 patients were recruited, and 60 of them fulfilled the inclusion criteria. Of 60 included patients, 52.3% (n=32) achieved total oral intake and had their NG tube removed before discharge. The mean number of days required to achieve total oral intake and NG tube removal was 18.3±14.3. 61.7% (n=37) of patients were able to maintain oral intake three meals a day at discharge. There was no complication within 3 months follow up and none of these patients required NG tube reinsertion.

Conclusion

Our nasogastric tube removal program has shown to assist clinical staffs to screen for suitable candidates, while improving the success rate of NG tube removal. Therefore, Establishment of a standardized protocol with practical execution for NG tube removal could improve healthcare quality in patients with prolonged NG tube use.