Reduce the replacement of nasogastric tube among home care patients

According to the annual quality control report within a home care unit, a baseline replacement rate of nasogastric tubes was recorded as 6.65% in 2008. In reference to this observation, we carried out a project to reduce the nasogastric tube replacement rate in a home care unit. From our analysis, we found that the causes of the high nasogastric tube replacement rate included the following: (1) a lack of a clinical pathway for standard nasogastric tube care (2) inappropriate education programs resulting in caregivers' lack of knowledge (3) a lack of a substitute program for restraint and (4) inappropriate techniques to firm the nasogastric tube. Having identified these problems, the following interventions were proposed to address them: (1) the implementation of a nasogastric tube replacement nursing care tracking form; (2) the establishment of standard techniques in nasogastric tube care to stabilize the tube; and (3) the provision of an illustrated education booklet and poster in Chinese and other languages for non-Chinese carers, focusing upon an innovative technique to prevent the accidental removal of the nasogastric tube. After implementation of the intervention program, the unexpected nasogastric tube replacement rate was reduced to 0.98%. This study highlights the importance of an innovative technique combined with an education program that contributed to a control of the unexpected nasogastric tube replacement rate in a home care unit.