Most Proposed Topic :
Committed and Happy Staff (staff wellness / OSH / retention)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for less than 15 years)
Authors: (including presenting author): :
Fong KY(1), Chan HTA(1),Chau YN(1), Lau SF(2),Poon YM(3), Lau WYJ (4), Lee SC(1), CHU S (2), Tang YMV (1), Lui N (1),Li WH (1), Hui F(1), Chan KH (5), Ngai SC (4)
Affiliation: :
(1)Community Nursing Services, Kowloon Hospital, (2)Community Nursing Service, Kwong Wah Hospital,(3)Community Geriatric Assessment Team, Kwong Wah Hospital (4)Community Geriatric Assessment Service, Queen Elizabeth Hospital, (5)Community Nursing Services, Kwong Wah Hospital
Introduction: :
Food consumption is highly emphasized in Asian culture. The greeting "Have you eaten yet?" is popular in Asian society. Feeding is crucial for patients with dysphagia or poor oral intake. Nasogastric tubes (NGTs) are commonly used for enteral feeding to provide necessary nutrients and prevent complications. NGTs are typically secured to the nose and face with adhesive tapes. However, the proper securement method for NGTs is often neglected in the community particularly in residential care homes for the elderly (RCHE). Securement methods play a vital role in preventing NGT-related pressure injuries (PIs), which can cause pain, disfigurement, and tube dislodgement when too loose. Neglecting these outcomes can significantly impact one's quality of life.Furthermore, maintaining patient dignity is a fundamental aspect of healthcare, even when a patient has an NGT. Healthcare providers should prioritize patient comfort and well-being. Each patient should be treated with respect, empathy, and individualized care, taking into account their unique needs and preferences.Prevention is better than cure,it is essential to promote the importance of proper NGT fixation in the community.
Objectives: :
(i) To reduce the occurrence of NGT-PIs in the local RCHE (ii) To reduce the frequency of tube dislodgement (iii) To raise healthcare workers (HCWs) s’ knowledge on NGT-PIs and NGT related care (iv) To enhance patient quality of life
Methodology: :
The programme was conducted from June 2022 to August 2022 at a newly opened private RCHE that without nurse to support NGT care. Due to the absence of nurses, there is a demand to enhance the nursing care provided, which is why the facility was selected for the programme. Convenience sampling was used to recruit residents and HCWs. The inclusion criteria of residents were: (i) on nasogastric feeding (ii) no allergy history of adhesive tape (iii) living in the selected RCHE. The training session consisted of two parts: an educational talk on NGT care and a workshop on NGT fixation care regime. HCWs were required to complete a knowledge test before and after the training session to assess their level of knowledge and skill performance throughout the programme. Various materials, such as posters, pocket cards, and education pamphlets, were provided to HCWs to guide them during the implementation process, ensuring equal implementation and facilitating programme sustainability. The pre-post assessment was conducted to evaluate NGT care knowledge, NGT fixation skills, pressure injury occurrence and healing progress.
Result & Outcome: :
RESULTS: 14 patients and 14 healthcare workers (HCWs) participated in this programme. The paired t-test indicated a significant difference between the pre-post knowledge test scores (P<0.001; SD: 1.27) and the pre-post skill empowerment scores (P<0.001; SD: 2.067), respectively. The HCWs' scores increased by almost 60% after the training session. Most of the nasogastric tube-related pressure injuries (NGT-PIs) healed within seven days. The incidence of NGT-PI and NGT dislodgement gradually decreased from 43% to 0% and 35% to 0%, respectively. CONCLUSION: Proper fixation of a nasogastric tube has significant benefits for patients, improving their quality of life and reducing the need for certain services. Secure fixation reduces the risk of complications and discomfort, allowing patients to engage in daily activities with confidence and well-being. It also promotes independence and dignity, enabling social interactions without fear of tube displacement. Additionally, it has the potential to reduce the frequency of home visits by healthcare providers, decreasing the need for constant monitoring and intervention. This not only allows patients to maintain independence and comfort but also conserves healthcare resources. Overall, proper nasogastric tube fixation enhances patient well-being, reduces the need for services, and improves their overall quality of life.
