EP274 - A clinical audit on nasogastric tube placement documentation and adherence with NICE guidelines in general surgical patients across a district general hospital

Abstract Aims NICE provide clear guidelines on confirming correct nasogastric (NG) tube siting using pH testing of aspirates or with X-rays where indeterminate samples are drawn. We aimed to audit documentation following nasogastric tube insertion to ascertain adherence to NICE guidelines. Methods A single-cycle snapshot audit was conducted on all surgical inpatients who had nasogastric tubes inserted over their admission across a single-centre district general hospital general surgery department. Data was collected on indication for NG tube insertion (drainage or feeding), length of initial tube insertion, whether pH testing was used to confirm position, and whether correct tube placement has been confirmed by a competent person through x-ray where indeterminate samples were tested from NG aspirate (pH > 5.5). Results A total of 15 patients had an NG tube inserted over their admission with mean age 77.3 years (range 47-97). 60% of patients had correctly documented confirmation of NG tube siting. 4/15 NG tubes were inserted for feeding purposes (26.7%), all of which were documented correctly. Only 45.5% of NG tubes for drainage were documented correctly and only 33.3% of all NG tubes had length of insertion documented. Where pH testing was inconclusive, a chest X-ray was requested for all patients and sufficiently documented by a doctor qualified to confirm position. No complications relating to NG tubes occurred across the audit study. Conclusions Implementation of improvement measures are warranted to improve overall adherence with NICE guidelines and prevent risk of incorrect confirmation of NG tube siting.