Outcomes of Utilizing Novel Versus Traditional Method of Length of Gastric Tube Insertion in Critically Ill Patients

Document Type : Research articles

Authors

1 Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

2 Critical medicine, Faculty of medicine, Alexandria University

Abstract

Background: Efficient positioning of the gastric tube in unconscious individuals in ICU remains difficult compared to its application in conscious patients. Therefore, innovative technique and procedure used for these patients to minimize complication and achieve better outcomes by measuring the distance from xiphisternum to earlobe to (nose/mouth) plus ten centimeters, as the tube containing a guidewire (as a stylet) reached around 20 cm, the nurse detects cricoid cartilage and pushed it outward and rightward in a guided manner could provide the best estimate of internal length of GT to be at an optimal position for feeding. Objective: To compare outcomes of utilizing novel versus the traditional method of the length of gastric tube insertion in critically ill patients. Settings: : at the ICUs of the Alexandria University Main Hospital (AUMH) in the General ICUs namely; General ICU (unit III) and continuous renal replacement therapy (CRRT) ICU. Subjects A Convenience sample of 60 adult unconscious critically ill patients from both genders, their ages ranged from 18 to 65 years constituted the subjects for this study. The sample was equally assigned into two equal groups (30 patients in each): group “A” the control group were subjected to the traditional method of insertion, Group B; patients were subjected to the novel method of insertion. Tools: Two tools were utilized to collect the data of this study. The tool I namely the ''gastric tube insertion assessment tool''. was utilized to collect the data of this study. This tool was developed by the researcher after reviewing the related literature. Tool II namely ‘ gastric tube insertion outcomes'' This tool was adopted from (Santos et al.,2016). Results: Mean number of gastric tube insertion trials was 1.03±0.183 and 1.47±0.571 for the study and control group respectively with a significant difference between the two groups (P= 0.000). The mean time elapsed or required for insertion of GT was 5.27±1.437 and 12.30±2.521 for the study and control group respectively with a significant difference between the two groups (P= 0.000). Conclusion: The present study revealed that the novel method group had the shortest duration of GT insertion, which ranged from 4 to 6minutes. While the traditional group had a longer insertion time which ranged from 10-12 minutes. the novel method saves the nurse’s time and effort during GT insertion, which decreases the patient’s anxiety, trauma occurrence, and pain. Recommendations: A teaching program should be conducted to raise awareness of critical care nurses about a novel method of gastric tube insertion that may help in saving time, effort and prevent serious complications.

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