Effectiveness of an educational intervention to improve nurses’ knowledge on pediatric nasogastric intubation

Abstract

Objective. To establish the effectiveness of an educational intervention to improve nurses' knowledge on pediatric nasogastric intubation. Methods. Multicenter, quasi-experimental, pre-and post-test study using a theoretical educational intervention based on bibliographic evidence and assessment of its effectiveness after 4 months. Results. Delivered questionnaires: 1019. Valid questionnaires: 557 (54.66 %) pre-test and 246 (24.14 %) post-test. Pre-and post-test answers indicated that the implied risk always entailed by the procedure had been perceived by 53.2 % and then increased to 70.7 % (p < 0.001). Nasogastric (NG) tube size was chosen using tables by 4.3 % of participants, and increased to 24.6 % (p < 0.001). The length of NG tube to be inserted as measured by the nose-ear-midumbilicus distance (NEMU) method increased from 34.2 % to 81.3 % (p < 0.001). Confirmation of NG tube placement prior to use increased from 73.1 % to 86.5 % (p < 0.001). Confirmation of the five rights (patient, drug, dosage, route, and timing) prior to NG tube use increased from 85.6 % to 91 %. In relation to confirmation methods, the perception that auscultation was unsafe improved from 11.7 % to 31.1 % (p < 0.001), and its use reduced from 95.1 % to 81.6 %. The perception that the measurement of gastric pH was safe increased from 71.3 % to 91.1 % (p < 0.001), and its use rose from 7.6 % to 54.3 % (p < 0.001). Conclusions. The educational intervention was effective to increase nurses' knowledge on pediatric nasogastric intubation.

Effects of implementation strategies aimed at improving high-value verification methods of nasogastric tube placement: A systematic review

“…Sixty-four full-text studies were obtained and screened after the titles and abstracts were screened, and 52 were excluded. Finally, 12 articles ( 17 , 18 , 20 – 29 ) were included and used for qualitative synthesis in this review ( Figure 1 ). The excluded articles were due to (1) studies that did not have a reference group ( n = 23), (2) studies that did not include implementation strategies to improve high-value verification methods of NGT placement ( n = 16), and (3) other (e.g., full text was not available, no outcomes showed on the volume of the high-value method, combined results of pH/X and other methods) ( n = 13).…”

“…Five studies obtained a score of 7 ( 17 , 21 , 22 , 24 , 29 ). Two studies obtained a score of 8 ( 18 , 26 ). Most studies did not obtain a high score, which was primarily the result of a low score on the “establishment control group” and “outcome measured in a reliable way” items.…”

“…Most studies were performed in the United States (USA) ( n = 4) ( 17 , 22 , 25 , 28 ) and the United Kingdom (UK) ( n = 4) ( 20 , 23 , 24 , 27 ). Of the 12 included studies, three focused their implementation strategy on improving pH testing ( 17 , 26 , 29 ), three on improving X-ray ( 23 – 25 ), and six on improving these two methods ( 18 , 20 – 22 , 27 , 28 ). Of the 9 studies ( 17 , 18 , 20 – 22 , 26 – 29 ) that used pH testing, four used a pH level of 5.5 as the cutoff point ( 20 , 26 , 27 , 29 ), three used a pH level of 5 as the cutoff point ( 17 , 18 , 22 ), one used a pH value of 4 as the cutoff point ( 28 ), and one used a pH value of 6 as the cutoff point ( 21 ).…”

“…Descriptions of implementation strategies (e.g., actor, action, action goal, and dosage) must be specific and clear enough to support repeatability in both research and practice, similar to all intervention studies ( 16 ). To improve the high-value verification methods of NGT placement, many implementation strategies have been performed in some studies ( 17 , 18 ). However, an understanding of implementation strategies aimed at improving high-value verification methods of NGT placement and the effectiveness of these different strategies is lacking.…”

New Flexible Tip Bougie catheter for difficult airway intubation. A randomized, crossover pilot study

“…Performed with a Miller or Macintosh blade laryngoscope in many cases can be difficult to perform or completely ineffective. This is particularly the case when intuba- tion is performed by people without direct laryngoscopy experience [8][9][10][11], during cardiopulmonary resuscitation, when continuous chest compression is performed [12][13][14], in the case of intubation of patients with immobilized cervical spine [15][16][17], or patients with difficult airways [18][19][20].…”