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Related Experiment Videos

Risk management, or just a different risk?

Y Freer1, A Lyon

  • 1Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, Scotland, UK.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 9, 2006
PubMed
Summary

Most neonatal units still use litmus paper to test nasogastric tube placement despite clinical alerts, indicating poor adoption of evidence-based practice changes for infant safety.

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Area of Science:

  • Neonatal care
  • Clinical practice change
  • Patient safety

Background:

  • Clinical alerts are issued based on national adverse incident reporting.
  • Mandatory practice changes often lack supporting evidence, leading to clinician resistance.
  • Lack of evidence for safety is a key barrier to implementing new clinical guidelines.

Purpose of the Study:

  • To assess the implementation rate of using pH paper instead of litmus paper for nasogastric tube position testing in UK neonatal units.
  • To evaluate adherence to clinical alerts regarding changes in nasogastric tube testing methods.

Main Methods:

  • A questionnaire survey was distributed to all UK neonatal units with over 12 cots.
  • Response rate was 80% (165 out of 207 units).

Main Results:

  • Fifty-five percent of responding neonatal units continued to use litmus paper.
  • All units utilized supplementary testing methods not recommended by best practice statements.
  • Significant variability was observed in the pH thresholds considered safe for feeding.

Conclusions:

  • Over half of neonatal units had not switched to pH paper nine months post-alert.
  • Continued use of supplementary tests highlights persistent practice variations.
  • The study underscores the need for evidence-based recommendations, not just reactive changes, in clinical practice.

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