title: [Project to Reduce the Incidence Rate of Nasogastric Tube Slippage in the Rehabilitation Ward].
abstract: BACKGROUND
  Nasogastric (NG) tubes are used for providing nutrition to patients who have difficulties swallowing. However, the difficult process of repeatedly inserting NG tubes may lead to gastric erosions.
  
  
  OBJECTIVE
  The rehabilitation ward in this study had an NG tube slippage rate of 2.26% in 2012, significantly higher than the same rate in 2011. A proposal was developed to design better techniques for nurses to perform NG tube insertions in order to decrease the rate of NG tube slippage.
  
  
  METHODS
  The following were identified as the major causes of NG tube slippage: (1) caretaker is unfamiliar with NG tube care instructions, (2) caretaker disengages NG tube constraints, and (3) improper rotation of patients or carelessness when turning patients. Therefore, the following solutions were proposed: (1) establish an NG tube safety standard operating procedure, (2) publish bilingual (English and Bahasa Indonesia) pamphlets providing instructions on the correct method of securing and placing the NG tubes, (3) make bilingual (English and Bahasa Indonesia) instructional videos showing the correct method for securing and placing the NG tubes, (4) fabricate a novel tube constraint tool (the constraint ball) that is easy to use, (5) install creative bedside NG tube warning signs, and (6) reinforce the importance of NG tube constraint and placement among caretakers.
  
  
  RESULTS
  The NG tube slippage rate was reduced from 2.26% to 0.77%, and was maintained at 0.75% during the follow-up period. The caretaker assessment further showed 100% understanding of the implemented NG tube safety procedures.
  
  
  CONCLUSIONS
  This proposal was established using literature research, problem identification, and creative problem solving to achieve an effective reduction in NG tube slippage as well as to enhance nursing quality.
authors.affiliation: Department of Nursing, Chung Shan Medical University Hospital, Taiwan, ROC.
authors.forename: Chiu-Chu
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Chung Shan Medical University Hospital Chung Shing Branch, Taiwan, ROC.
authors.forename: Wei-Ling
authors.initials: WL
authors.lastname: Su
authors.affiliation: Department of Nursing, Chung Shan Medical University Hospital, Taiwan, ROC. csha481@csh.org.tw.
authors.forename: Ai-Cheng
authors.initials: AC
authors.lastname: Li
authors.affiliation: Chung Shan Medical University Hospital Chung Shing Branch, Taiwan, ROC.
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Lin
mesh_terms: D006801:Humans; D015994:Incidence; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D012047:Rehabilitation Centers
keywords: nasogastric tube slippage; nursing; rehabilitation unit