Authors (including presenting author) :
Ng BCM, Wan VSF, Ho WKW
Affiliation :
Accident and Emergency Department, Caritas Medical Centre
Introduction :
For patients who attending A&E due to NG tube dislodgement and require re-insertion of NG tube were mostly treated as Triage Category 4 cases. They usually had to wait for at least more than one hour for doctor consultation before having re-insertion of the NG tube. By the time of all the investigations and interventions completed, the time for resuming feeding are usually several hours after the dislodgement of the NG tube. It leads to the increased risks of dehydration, malnutrition of patients as well as overcrowding of A&E. In view of the risks mentioned above, a nurse-initiated NG tube re-insertion protocol has been implemented from June 2017.
Objectives :
1. To shorten the door-to-procedure time and possibly the length of stay in A&E of those patients with NG tube dislodgement
2. To minimize overcrowding of A&E environment
Methodology :
By following the department protocol, nursing staff can perform re-insertion of NG tube before doctor consultation. This will shorten the door-to-procedure time.
Result & Outcome :
From 1/6/2017 to 31/5/2018, there were totally 46 Cat. 4 patients had re-insertion of NG tubes in A&E, CMC by adopting the captioned nurse-initiated protocol. When comparing to the waiting time of the Category 4 cases one year ago, the waiting time had been shortened from 53.8 minutes to 31 minutes. This facilitated doctors to make discharge decision as well as resuming feeding time earlier.
Hence, both medical and nursing teams showed positive feedback on this initiative as it reduced patient’s length of stay and improved patient’s well-being.
The captioned initiative has been adopted as an on-going practice in the department.
Co-location with:
