Updated Dietetic Prescribing Guidelines When Naso-Gastric Tube Feeding Under Physical Restraint Is Required: A Modified Nominal Group Technique Study.

INTRODUCTION

Naso-gastric tube (NGT) feeding under physical restraint is a lifesaving clinical intervention that is sometimes needed in mental health patients, particularly those with restrictive eating disorders. Initial guidance was published in 2020 and subsequently reviewed and updated to support dietitians in this specialist area.

METHODS

Using purposeful recruitment, we brought together specialist mental health dietitians from England, Wales, Scotland and Northern Ireland who work in inpatient child and adolescent mental health services or adult inpatient mental health services. We followed modified nominal group technique in the update of these guidelines. Nominal group technique has four stages. Stage one is for silent idea generation, stage two facilitates round-robin discussion, stage three is the discussion and refining of ideas and stage four the voting and ranking of ideas to generate consensus.

RESULTS

We have updated the clinical guidelines for dietetic prescribing when NGT feeding under physical restraint for a mental health condition is needed. This updated guideline promotes the least restrictive practice and encourages dietetic prescribing to be proportionate to medical risk.

CONCLUSION

We have provided an updated version of the dietetic prescribing guidelines when NGT feeding under physical restraint is needed. These guidelines now apply to mental health patients in general, not just those with Anorexia Nervosa and incorporate expert clinical opinion regarding strategies to wean off this clinical intervention.