Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements.

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.