{"id":225,"date":"2024-10-30T19:03:58","date_gmt":"2024-10-30T19:03:58","guid":{"rendered":"https:\/\/iims.uthscsa.edu\/isrn\/?page_id=225"},"modified":"2024-11-07T15:47:52","modified_gmt":"2024-11-07T15:47:52","slug":"collaborative-best-practice-guidelines-development-abstract","status":"publish","type":"page","link":"https:\/\/iims.uthscsa.edu\/isrn\/resources\/ereading-room\/abstracts\/collaborative-best-practice-guidelines-development-abstract\/","title":{"rendered":"Collaborative Best Practice Guidelines Development"},"content":{"rendered":"

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Primary Author:<\/td>\nDiane Baker, EdD, APN-BC<\/td>\n<\/tr>\n
Co-Principal Investigators\/Collaborators:<\/td>\nRobert Parker, MSN, Carla Lane, MSN, Lisa Young, MSN, Cindy Wooten, MSN<\/td>\n<\/tr>\n
Organization<\/td>\nSystem Nursing, BMHCC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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Abstract<\/h2>\n

Purpose<\/h3>\n

Establish gastrointestinal tube confirmation of placement best practice guidelines for adults in a 14 Hospital System with 4400 registered nurses.<\/p>\n

Background<\/h3>\n

Auscultation is no longer an acceptable practice for confirmation of gastrointestinal tube placement in adults. The changing landscape of managing the functions (lavage and gavage) of placement has increased in complexity related to patient safety. Radiologic confirmation remains the Gold Standard. The functions continue as foci of gastrointestinal tube studies.<\/p>\n

Materials & Methods<\/h3>\n

Integration of the Iowa model of evidence-based practice\/research (the adopted model for the system) for best practice guidelines development occurred. PICO question drafted by Medical Surgical Unit(s) RN\u2019s: What method of confirming nasogastric or enteral feeding tube placement is the most accurate for adult acute care hospital inpatients? A comprehensive literature review was conducted. Collaboration was a second methodology. Collaborating disciplines included radiology; nutrition services; laboratory; nursing practice, education, and informatics (manual and electronic documentation). The nursing practice and nursing education disciplines participated in drafting the guidelines. The other disciplines acted as reviewers.<\/p>\n

<\/h3>\n

The best practice guidelines are comprised of assessments (nare measurement, oral coiling, positioning, presence of radiologic confirmation on chart) interventions (NEX tube measurements, oral hygiene, positioning, residual gastrointestinal contents volume measurement), and documentation (all assessments and interventions). A Soft Chalk program is available. Simulation activity templates also are available. Executive summaries to the 14 hospital entities, affiliating schools of nursing, and medical staff complete the results. Chief Nursing Officers, hospital entity Nursing Staff development staff, and Nursing Research Council members share accountability for dissemination. Nursing Informatics provided EHR support during the documentation dissemination process. A plan to study the 4400 nurse\u2019s response to the auscultation change is underway.<\/p>\n

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Conclusion<\/h3>\n

Best practice guideline development for confirmation of gastrointestinal tube placement in adults was challenging to all disciplines involved. Patient safety was the driver.<\/p>\n

Bibliography<\/h3>\n

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\n\u00a9 Improvement Science Research Network, 2012<\/p>\n

The ISRN\u00a0published this as received and with permission from the author(s).<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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