Nurse initiated reinsertion of nasogastric tubes in the Emergency Department: A randomised controlled trial

Abstract

Background: Patients sometimes present to the Emergency Department (ED) for reinsertion of nasogastric tubes (NGT) because of tube dislodgement. They usually need to wait for a long time to see a doctor before the NGT can be reinserted. This study aimed at investigating the feasibility of nurse initiated NGT insertion for these patients in order to improve patient outcome. Methods: This is a prospective randomised controlled trial. Patients requiring NGT reinsertion were randomised to receive treatment by either nurse initiated reinsertion of NGT (NIRNGT) or the standard NGT insertion protocol. Questionnaires were given to both groups of patients, relatives and ED nurses afterwards. Outcome measures included door-to-treatment time, total length of stay (LoS) in the ED and the satisfaction of patients, relatives and nurses. Results: Twenty-two patients were recruited to the study and randomised: 12 in the standard NGT insertion protocol and 10 in the NIRNGT protocol. The door-to-treatment time of the NIRNGT group (mean = 45.6. min) was significantly shorter than the standard NGT insertion group (mean = 123.08. min; p= 0.003). No statistically significant difference was detected between the total ED LoS (p= 0.575). Patients, relatives and nurses were generally satisfied with the new treatment protocol. Conclusion: Patients can undergo NGT reinsertion significantly faster by adopting a nurse initiated reinsertion of NGT (NIRNGT) protocol. © 2013 College of Emergency Nursing Australasia Ltd.