Nutrition and Dietetics, Cairns & Hinterland Hospital and Health Service, PO Box 902, Cairns, QLD, 4870, Australia; Nutrition and Dietetics, Sunshine Coast Hospital and Health Service, Birtinya, QLD, 4575, Australia.
Nutrition and Dietetics, Cairns & Hinterland Hospital and Health Service, PO Box 902, Cairns, QLD, 4870, Australia.
Clin Nutr ESPEN. 2023 Jun;55:308-313. doi: 10.1016/j.clnesp.2023.03.022. Epub 2023 Apr 10.
BACKGROUND & AIMS: To describe the process of credentialing and implementing dietitian insertion of nasogastric tubes (NGTs) in a regional setting in Australia, and report on patient outcomes, timeliness and safety of insertion, and staff acceptance.
An observational, mixed-methods study of service and patient outcomes was undertaken during the 2 years (2018-2020) following the implementation of dietitian credentialling for the insertion and management of NGTs. Data relating to the insertion of NGTs by credentialled dietitians were collected prospectively. A staff survey was circulated during and after the data collection period. Data has been reported descriptively.
The model of care was successfully implemented with two dietitians credentialed to insert NGTs. There were 38 unique occasions of NGT insertions for 31 individual patients. Eighty-seven percent (n = 33) of cases were inpatients. NGT insertion was successfully performed by the dietitian 82% of the time (n = 31). No medical complications relating to NGT insertion were reported following a dietitian inserted NGT, with the exception of one incidence of mild epistaxis. The average insertion time was 25.5 min (14.1), the average number of insertion attempts by a dietitian was 1.7 (1.27) and on one occasion more than one x-ray was required.
This study supports the recommendations of Dietitians Australia that this model of care is viable as an extended scope of practice model of care for dietetic departments across Australia. This evaluation adds to the evidence base for extended scope of practice and informs future directions for the service and training of dietitians.
描述在澳大利亚的一个地区环境中对营养师进行认证并实施鼻胃管（NGT）插入的过程，并报告患者结局、插入的及时性和安全性以及员工接受度。
在营养师获得 NGT 插入和管理认证后的 2 年（2018-2020 年）期间，对服务和患者结局进行了观察性、混合方法研究。前瞻性收集了与经认证营养师插入 NGT 相关的数据。在数据收集期间和之后，分发了员工调查。数据以描述性方式报告。
成功实施了护理模式，有两名营养师获得认证以插入 NGT。共有 31 名个体患者的 38 个独特 NGT 插入机会。87%（n=33）的病例为住院患者。营养师成功完成 NGT 插入 82%的时间（n=31）。在营养师插入 NGT 后，没有报告与 NGT 插入相关的医疗并发症，除了一例轻度鼻出血。平均插入时间为 25.5 分钟（14.1），营养师的平均插入尝试次数为 1.7（1.27），有一次需要进行多次 X 光检查。
本研究支持澳大利亚营养师的建议，即这种护理模式是可行的，可作为澳大利亚所有营养部门的扩展实践护理模式。该评估增加了扩展实践范围的证据基础，并为服务和营养师培训的未来方向提供信息。
