title: Implementation of the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit.
abstract: OBJECTIVE
  This project was designed to implement the best practice in nasogastric tube feeding of critically ill patients in a neurosurgical intensive care unit.
  
  
  METHODS
  Clinical audit software programmes of the Joanna Briggs Institute (Practical Application of Clinical Evidence System and Getting Research Into Practice) were used in this project. A baseline audit, feedback, follow-up audit cycle was followed. The audit team analysed the results of the baseline audit, conducted a situational analysis and formulated and implemented a strategic plan to improve the nasogastric tube care.
  
  
  RESULTS
  Initially, the compliance with the criteria varied from 0% to 87%. The Getting Research Into Practice phase of the project identified several barriers of each criterion. After implementation of best practice, the following audit showed an improvement in all criteria, ranging from 33% to 95%. Marked improvement was achieved in the criteria that were not strictly required by local standards, such as rechecking the tube position, assessing the gastric residual volume and maintaining the airway cuff pressure.
  
  
  CONCLUSIONS
  The project had some success in improving the practice of nasogastric tube feeding. Collaboration, education, monitoring and a reward system were the key elements used to drive the project. Further actions and changes are expected to produce 100% compliance.
authors.affiliation: Huashan Hospital affiliated to Fudan University, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Xuefang
authors.initials: X
authors.lastname: Ren
authors.forename: Weilin
authors.initials: W
authors.lastname: Shi
authors.forename: Hong
authors.initials: H
authors.lastname: Jiang
mesh_terms: D019985:Benchmarking / Q000379:methods / Q000592:standards; D002681:China; D016638:Critical Illness; D004750:Enteral Nutrition / Q000451:nursing* / Q000592:standards; D055318:Evidence-Based Nursing / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal / Q000451:nursing* / Q000592:standards; D019635:Neurosurgical Procedures; D009731:Nursing Audit