Nursing Care Guidelines for Reducing Hospital-Acquired Nasogastric Tube-Related Pressure Injuries

Area of Science:

• Nursing
• Patient Safety
• Medical Device Management

Background:

• Increasing incidence of hospital-acquired pressure injury of the nares linked to medical devices, specifically nasogastric tubes.
• Majority of injuries occurred in intensive care unit patients.
• Lack of formal organizational guidelines for prevention.

Purpose of the Study:

• To decrease the incidence of nasogastric tube-related hospital-acquired pressure injury.

Main Methods:

• Utilized a process improvement model (define, measure, analyze, improve, control).
• Compared incidence rates pre-intervention (2015) and post-intervention (2016).
• Developed and implemented evidence-based guidelines using the 'CLEAN' mnemonic: correct tube position, stabilize tube, evaluate area, alleviate pressure, note date/time.

Main Results:

• 100% decrease in nasogastric tube-related hospital-acquired pressure injury incidence (0.13 to 0.0 per 1000 patient days).
• Sustained reduction for one year post-implementation.
• Slight increase observed later due to staff knowledge gaps.

Conclusions:

• Clear, specific guidelines for nasogastric tube assessment and securement effectively reduced hospital-acquired pressure injuries.
• Evidence-based interventions are crucial for preventing device-related patient harm.
• Ongoing staff education is necessary to maintain guideline effectiveness.