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Feeding tube guidance aims to boost patient safety

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Guidance has been issued to NHS organisations in England and Wales aimed at lowering the number of incidents when harm is caused to adults, children and infants through misplaced nasogastric feeding tubes.

The National Patient Safety Agency (NPSA) has updated a previous alert released in 2005 which provided guidance for making sure nasogastric tubes are inserted correctly into the stomach.

A total of 21 people have died and 79 people have been hurt since the completion date for the 2005 alert. This has been due to feeding incorrectly going into the lungs because of misplaced nasogastric tubes.

The Patient Safety Alert sets out a specific set of steps to go through every time a nasogastric feeding tube is inserted and asks clinicians to consider three essential questions:

  • Is nasogastric feeding the right decision for this patient?
  • Is this the right time to place the nasogastric tube and is the appropriate equipment available?
  • Is there sufficient knowledge/expertise available at this time to test for safe placement of the nasogastric tube?

Dr Suzette Woodward, director of patient safety, NPSA, said: “It is unacceptable that patients are still dying from misplaced nasogastric feeding tubes.

“This new alert emphasises that pH remains the first line test to ensure the nasogastric tube is in place and provides additional information to support the safe interpretation of x-rays to check the placement of nasogastric tubes. Following these simple steps will make this procedure safer.”

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