Essentials of Evidence-Based Practice Part 5: Recommending and EvidenceBased Practice Change

 
Description of Current Problem
! The blind insertion of nasogastric tube (NGT) poses a potential risk for misplacement which may lead to dangerous outcomes
(Irving, Lyman, Northington, Bartlett, & Kemper, 2014).
! Verification of NGT at this facility is unsafe. There are several inconsistencies and nurses have been noted using unsafe
methods (Northington, Lyman, Guenter, Irving, & Duesing, 2017). The need for standardization and evidence-based practice
is grave.
! pH testing of gastric aspirate of 5.5 or less is reliable and abdominal imaging studies remains the gold standard for NGT
verification (Irving, Lyman, Northington, Bartlett, & Kemper, 2014).
Scope of the Issue
! Recent studies have shown that more than 88% of nurses are using non-evidence-based methods for verification of
nasogastric tube placement leading to serious patient harm.
! The state of Pennsylvania is one of a few in the United States that mandate hospitals to report sentinel events related to NGT
misplacement
! The study analyzed enteral feeding tube misplacements over a 6-ye