Leadership Plan
Successful implementation of NG tube safe practices includes the following:
- Commitment from hospital governance and senior administrative leadership to Identify and maintain awareness of performance gaps within their organization.
- All leadership and healthcare professionals will fully understand the need for change by identifying performance gaps in their own care area.
- Healthcare leadership must take an active role in facilitating process changes by providing necessary resources, removing barriers, giving their time and attention, as well as encouraging process improvement.
- Goals that are clearly defined and measurable, effective communication and collaboration, encouraging clinical/safety leadership, and being supportive during the change period are ways healthcare leadership will assist with improvement initiatives.
- Hospital governance at all levels and senior administrative leadership must be engaged and demonstrate their own commitment to implementing the new process change. Senior leaders, directors, physicians, managers, and unit leaders are expected to be engaged as they have a significant role in the process improvement process.
To sustain the change, acceptance and accountability building is essential. Success and sustainability are more likely to be the outcome of the initiative when the proposed changes are accepted by those primarily responsible for the implementation.
Practice Plan
Safe equipment
- All NGTs should be radio-opaque throughout their length with external centimeter length markings to be used to detect post-insertion tube movement
- When checking pH use a product that is licensed for medical use.
Staff training and competency
- All staff who place NGTs should be specifically trained in this procedure. Competency should include:
o Knowledge of contra-indications for bedside placement, such as basilar skull fracture.
o Awareness of clinical situations that place patients at high-risk for misplacements such as increased work of breathing or tachypnea
o Demonstrated skill in the use of any technology to assist with placement (see 'Technology Plan' below)