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- Johansson, Sara, et al.
(författare)
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Nytt forskningsprojekt om medicinsk häfta
- 2023
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Ingår i: Sårjournalen. - : Sårsjuksköterskor i Sverige. - 2003-8054. ; :1, s. 12-12
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Forskningsöversikt (populärvet., debatt m.m.)
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| 4. |
- Torsy, Tim, et al.
(författare)
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Accuracy of the corrected nose-earlobe-xiphoid distance formula for determining nasogastric feeding tube insertion length in intensive care unit patients : A prospective observational study
- 2020
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 110
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Tidskriftsartikel (refereegranskat)abstract
- Background: As nasogastric feeding tube insertion is a frequently applied, non-risk-free nursing technique, a high level of evidence-based nursing care is required. Little evidence is available regarding the accurate determination of the insertion length of nasogastric feeding tubes. The method of using the nose-earlobe-xiphoid distance as measurement is inadequate and not supported by evidence. Findings from a recent randomized trial led to an alternative calculation: the corrected nose-earlobe-xiphoid distance formula: (nose-earlobe-xiphoid distance × 0.38696) + 30.37 + 6 cm.Objectives: To test the accuracy of the corrected nose-earlobe-xiphoid distance formula for determining the required nasogastric feeding tube insertion length in adults admitted on an intensive care unit and to investigate the probability to successfully obtain gastric aspirate for pH measurement.Design: Prospective, single‐centre observational study.Participants and methods: Adult intensive care unit patients in a general hospital (N=218) needing a small-bore nasogastric feeding tube were included between March and September 2018. Correct tip positioning was defined as a tube tip located > 3 cm under the lower esophageal sphincter. Tip positioning was verified using X-ray.Results: All nasogastric feeding tube tips were correctly positioned > 3 cm under the lower esophageal sphincter. The chance of successfully obtaining gastric aspirate within 2 hours after placement of the tube was 77.9%.Conclusions: With all tips positioned > 3 cm in the stomach and zero tubes migrating back into the oesophagus, the corrected nose-earlobe-xiphoid distance formula can be considered a more accurate method to determine nasogastric feeding tube insertion length.
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| 6. |
- Torsy, Tim, et al.
(författare)
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Factors associated with insufficient nasogastric tube visibility on X-ray : a retrospective analysis
- 2021
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Ingår i: European Radiology. - : Springer. - 0938-7994 .- 1432-1084. ; 31:4, s. 2444-2450
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Chest X-ray imaging is frequently used for verifying the position of a blindly inserted nasogastric tube. A high-quality X-ray increases the likelihood of conclusive visibility of tube tip positioning, thus avoiding risks due to a misplaced tube (e.g., pulmonary intubation, pneumothorax, small bowel insertion). Therefore, this study aims to determine patient-related and environmental factors affecting the visibility of nasogastric tubes on X-ray in adults.Methods: A retrospective descriptive analysis of routinely collected clinical datawas performed on all included patients (N = 215) from a prospective randomized trial in a general hospital. A chest X-ray was taken of each patient needing a nasogastric feeding tube, after which visibility and positioning of the tube on X-ray was independently evaluated by 3 radiologists.Results: In 14.9% (n = 32) of all patients, image quality was insufficient, so no conclusive visibility of nasogastric tube positioning could be found. A patient-related predictor regression model (sex, age, body mass index) explained 21% of variance for an insufficient visibility of the nasogastric tube (Nagelkerke R2 = 0.21). An environmental factor regression model demonstrates a guidewire being inside the tube or not during X-ray as a predictor for a conclusive visibility on X-ray.Conclusions: High body mass index, male sex, and the absence of a guidewire inside the nasogastric tube at the time of chest Xray are associated with a risk of insufficient visibility of the tube on X-ray. Patient profiles can be defined in which supplementary attention is needed when obtaining chest X-rays whose purpose is to confirm nasogastric tube positioning.
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| 7. |
- Torsy, Tim, et al.
(författare)
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The accuracy of methods for determining the internal length of a nasogastric tube in adult patients : A systematic review
- 2022
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Ingår i: American Journal of Clinical Nutrition. - : Oxford University Press. - 0002-9165 .- 1938-3207. ; 116:3, s. 798-811
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Blind insertion of nasogastric tubes is performed for several reasons: Nutrition and medication administration, gastric aspiration/decompression, and other, diagnostic reasons. Accidental intraesophageal and intestinal placement is common, and increases the risk of serious complications. Therefore, accurate determination of the internal length of the nasogastric tube prior to placement is considered a prerequisite for achieving correct gastric positioning.OBJECTIVES: To identify, assess and summarize the evidence on the accuracy of methods for determining the internal length of a nasogastric tube in adults.METHODS: Cochrane Library, EMBASE, PubMed, CINAHL, and Web of Science were searched up to January 31, 2022. Studies were eligible when reporting data on the accuracy of methods for determining internal nasogastric tube length in adults. Study selection, risk-of-bias assessment, and data extraction were performed independently by two investigators. Risk-of-bias was assessed using the Cochrane Risk-of-Bias Tool and the JBI Critical Appraisal Checklist for Cross Sectional Studies. A narrative synthesis of the results was then conducted.RESULTS: Twelve papers were included in this review. All studies were observational, cross-sectional in nature, except for one RCT. Ten methods for determining the internal length of a nasogastric tube were described. Correctly positioned NG tubes ranged from 13% to 99%. Results showed that the nose-earlobe-xiphoid (NEX) distance + 10 cm (M = 59.9 - 60.7 cm) and (NEX x 0.38696) + 30.37 + 6 cm (M = 56.6 - 56.7 cm) could potentially result in accuracy as high as 97.4 and 99.0%, respectively.CONCLUSIONS: Current data do not provide conclusive evidence of 100% accuracy in finding a correctly placed nasogastric tube when using a method for determining the internal length. Blind placement, using any of the documented methods, cannot be considered safe without additional verification of tube tip positioning. Furthermore, using any of these ten methods does not reduce the risk of pulmonary intubation.
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| 10. |
- Antierens, Alain, et al.
(författare)
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How much of Toyota's philosophy is embedded in health care at the organisational level? A review
- 2018
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Ingår i: Journal of Nursing Management. - : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 26:4, s. 348-357
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Forskningsöversikt (refereegranskat)abstract
- AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies.BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care.EVALUATION: Sixty studies were identified for the final analysis.KEY ISSUE(S): Some Toyota Way principles appear more deeply embedded in health care institutions than others are.CONCLUSION: Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse.IMPLICATIONS FOR NURSING MANAGEMENT: This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level.
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