Reducing Inadvertent Gastric Tube Removal in NICU: A Quality Improvement Initiative

To assess the impact of quality improvement (QI) interventions on lowering inadvertent removal of gastric tubes (IRGT) incidence in a Chinese territory neonatal intensive care unit (NICU).

A multidisciplinary approach was employed, incorporating sequential interventions targeting identified causative factors. The study was conducted in three phases-pre-implementation, implementation, and post-implementation. Baseline characteristics and process measures were assessed to evaluate the impact of the interventions.

Monthly IRGT incidence significantly decreased from 10.3 at baseline to 2.0 events per 100 tube placement days after post-intervention, with the reduction sustained over a twelve-month period. Furthermore, compliance with the interventions and the use of nasogastric tubes both significantly increased following the implementation of the four-phase interventions.

This study demonstrates that a structured, multidisciplinary QI approach can significantly lower the incidence of IRGT in the NICU. This structured QI initiative demonstrates a reproducible model to enhance neonatal safety by reducing gastric tube dislodgement.