Implementation of parent‐focused nasogastric tube simulation program improves preparedness and anxiety with tube placement

OBJECTIVE: Little data exist on the use of simulation training to improve parents'/caregivers' technical preparation and anxiety with performing nasogastric tube (NGT) care. The goal of this study was to compare the outcomes of three forms of NGT teaching: standard education at the time of discharge, standard discharge education with an additional outpatient gastroenterology (GI) nurse clinic teaching session, or standard discharge education with NGT simulation. METHODS: Parents/caregivers of infants and children discharged with a newly placed NGT and had follow-up within our Aerodigestive Center at Boston Children's Hospital (between February 2020 and February 2023) were prospectively recruited to participate. The primary outcome was to assess the impact of NGT simulation education on parental/caregiver technical comfort with NGT care. Secondary aims included impact of parental/caregiver anxiety with NGT cares/placement and the subsequent use of emergency room visits, outpatient GI visits, and hospitalizations within 6 weeks of enrollment. RESULTS: A total of 52 parents/caregivers participated: 28 (53.8%) received standard discharge education only, 7 (13.5%) received standard discharge education and a GI nursing teaching visit, and 17 (32.7%) received standard discharge education and enrolled in an NGT simulation class. Parents/caregivers enrolled in the simulation class showed significant improvement in technical preparation scores in managing (p = 0.005) and replacing (p = 0.001) dislodged NGTs and had decreased anxiety scores with NGT replacement (p = 0.003). No differences in emergency room, GI clinic visits, or hospitalizations were seen. CONCLUSION: Implementation of NGT simulation classes for parents/caregivers of NGT-dependent patients had improved preparedness with managing and replacing dislodged NGTs and decreased anxiety with performing these tasks.