Research

Running head: Annotated Bibliography I 2

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

Student Name

Nursing Research and Evidence-Based Practice

Professor’s name

Monday, September 20, 2021

Summary

Despite gaining little attention, nasogastric tube-related Hospital Acquired Pressure Injuries (NGT-HAPIs) incidences are increasing in hospitals, especially on patients under critical care (Schroeder & Sitzer, 2019, 55). Such injuries are costly in terms of litigation and the cost of treatment. They can cause discomfort to the patient, including pain and disfiguration. Researchers realized that although there is a need to reduce NGT-HAPIs, hospitals did not have a clear and specific guideline for the use of nasogastric tubes. Researches then used recommendations from literature review and developed and implemented evidence-based practice that prevents NGT-HAPIs. Researchers applied quasi-experimental design in undertaking their quality improvement project. they used DMAIC quality improvement model in Magnet hospital in southern California where data was collected before and after the intervention. Results indicated that after the new guidelines were implemented, the incidences of NGT-HAPIs reduced from 0.13 per 1000 patient days in 2015 to zero per 1000 patient days in 2016.

Assessment

Limited literature exists on the best practices in preventing NGT-HAPIs and the best way to handle NGT (Schroeder & Sitzer, 2019, 56-57). Although NPUAP has some recommendations and best practices that hospitals can adhere to, specific handling of NGT to reduce injuries does not exist. This source gives clear guidelines that if implemented, can lead to the reduction of NGT-HAPIs. The development of mnemonic “CLEAN” with the frequency of securement helps in reducing NGT-HAPIs. I find the information reliable since the research was quality improvement research. The process improvement model used in the methodology was backed with recommendations from current literature as well as NPUAP. Authors are reputable individuals who have practiced nursing in their careers as exhibited by the senior positions they hold. However, the research was conducted in an organization that is highly reliable where all staff proactively seek to prevent harm to the patients (Schroeder & Sitzer, 2019, 56). If the recommendations were to be replicated in hospitals where resources are limited and where patient safety is not proactively approached, then attaining zero NGT-HAPIs is not practical. The possible extraneous variable includes patients in critical conditions where NGT-HAPI is not avoidable. The type of nasogastric tubes also varies and each exerts different pressures. The objective statement of the source is to decrease NGT-HAPI and the findings indicated that adoption of specific guidelines can actually reduce NGT-HAPIs.

Reflection

The source enlightened me on the extent of NGT-HAPIs and their implications on both the patient and the hospital. I gained more information on the efficacy of evidence-based practice when applied in a given setting. By highlighting the importance of the creation and adoption of specific guidelines to reduce NGT-HAPIs, the source uses a process improvement methodology that will be useful in my research. This source will help me to link increased incidences of NGT-HAPIs to lack of commitment and motivation by hospital staff to reduce nasogastric-tube-related injuries. Before reading the article, I believed that more life-threatening issues needed focus as opposed to NGT-HAPIs but since it can be reduced to zero, it becomes part of avoidable injuries that only need commitment and a clear pathway to attain.

Reference

Schroeder, J., & Sitzer, V. (2019). Nursing Care Guidelines for Reducing Hospital-Acquired Nasogastric Tube–Related Pressure Injuries. Critical Care Nurse, 39(6), 54-63. https://doi.org/10.4037/ccn2019872