American journal of surgery · 2025
Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Kobzeva-Herzog Anna J, Nofal Maia R, Bodde Jacob, Smith Sophia M, Rosenkranz Pamela, Guez David, McAneny David, Siracuse Jeffrey J, Richman Aaron
Аннотация
BACKGROUND: We examined the success of a quality improvement initiative intended to prevent acute inpatient gastrostomy tube (g-tube) dislodgements.
STUDY DESIGN: This was a retrospective cohort study of adult inpatients ≥18-years-old who underwent new g-tube placement at our institution (September 2021-August 2023). A new nursing order and revised nursing education, which specified standardized g-tube care, was implemented in September 2022. The incidence of g-tube dislodgments was compared between the pre-intervention and post-intervention cohorts.
RESULTS: There were 555 g-tube placements, of which 236 occurred post-intervention. At one year after implementation, the compliance rate was 71.2 %. Patients with the new order had fewer dislodgements compared to those who did not have the order (8.3 % vs 29.4 %, P < 0.001). Multivariable analysis demonstrated use of the order was associated with a decreased risk of dislodgement (OR 0.51, CI 0.28-0.99, P = 0.046).
CONCLUSIONS: Multidisciplinary initiatives can reduce the likelihood of complications and improve patient outcomes.
STUDY DESIGN: This was a retrospective cohort study of adult inpatients ≥18-years-old who underwent new g-tube placement at our institution (September 2021-August 2023). A new nursing order and revised nursing education, which specified standardized g-tube care, was implemented in September 2022. The incidence of g-tube dislodgments was compared between the pre-intervention and post-intervention cohorts.
RESULTS: There were 555 g-tube placements, of which 236 occurred post-intervention. At one year after implementation, the compliance rate was 71.2 %. Patients with the new order had fewer dislodgements compared to those who did not have the order (8.3 % vs 29.4 %, P < 0.001). Multivariable analysis demonstrated use of the order was associated with a decreased risk of dislodgement (OR 0.51, CI 0.28-0.99, P = 0.046).
CONCLUSIONS: Multidisciplinary initiatives can reduce the likelihood of complications and improve patient outcomes.