title: Nurse initiated reinsertion of nasogastric tubes in the emergency department: a randomised controlled trial.
abstract: BACKGROUND
  Patients sometimes present to the Emergency Department (ED) for reinsertion of nasogastric tubes (NGT) because of tube dislodgement. They usually need to wait for a long time to see a doctor before the NGT can be reinserted. This study aimed at investigating the feasibility of nurse initiated NGT insertion for these patients in order to improve patient outcome.
  
  
  METHODS
  This is a prospective randomised controlled trial. Patients requiring NGT reinsertion were randomised to receive treatment by either nurse initiated reinsertion of NGT (NIRNGT) or the standard NGT insertion protocol. Questionnaires were given to both groups of patients, relatives and ED nurses afterwards. Outcome measures included door-to-treatment time, total length of stay (LoS) in the ED and the satisfaction of patients, relatives and nurses.
  
  
  RESULTS
  Twenty-two patients were recruited to the study and randomised: 12 in the standard NGT insertion protocol and 10 in the NIRNGT protocol. The door-to-treatment time of the NIRNGT group (mean=45.6 min) was significantly shorter than the standard NGT insertion group (mean=123.08 min; p=0.003). No statistically significant difference was detected between the total ED LoS (p=0.575). Patients, relatives and nurses were generally satisfied with the new treatment protocol.
  
  
  CONCLUSIONS
  Patients can undergo NGT reinsertion significantly faster by adopting a nurse initiated reinsertion of NGT (NIRNGT) protocol.
authors.affiliation: Trauma & Emergency Center, Accident & Emergency Department, Prince of Wales Hospital, Hong Kong. Electronic address: chococrystal@gmail.com.
authors.forename: Crystal Hiu Yan
authors.initials: CH
authors.lastname: Ho
authors.forename: Timothy Hudson
authors.initials: TH
authors.lastname: Rainer
authors.forename: Colin Alexander
authors.initials: CA
authors.lastname: Graham
mesh_terms: D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D004750:Enteral Nutrition / Q000295:instrumentation / Q000451:nursing; D005260:Female; D006723:Hong Kong; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods / Q000451:nursing*; D008297:Male; D009722:Nurse Practitioners; D024802:Nurse's Role; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011446:Prospective Studies; D019233:Retreatment / Q000451:nursing; D011795:Surveys and Questionnaires; D061665:Time-to-Treatment / Q000706:statistics & numerical data
keywords: Emergency nursing; Emergency service, hospital; Enteral nutrition; Nurse practitioner; Professional autonomy; Randomised controlled trial