Considering the role of medical radiation technologists to mitigate the care delivery problems associated with nasogastric tube verification and improve patient care.

ABSTRACT

INTRODUCTION: Misplaced nasogastric (NG) tubes can have deleterious consequences for patients, including death. Medical radiation technologists (MRTs) may be well-positioned to improve the NG tube verification process. The objective of this study was to identify the care delivery problems (CDPs) associated with verifying NG tube placement and to consider where MRTs may mitigate current challenges. METHODS: This study involved three sources of data; a data audit of NG tube chest x-rays (CXRs), a review of related incident reports, and a staff survey, all conducted in the general radiography departments at two large, affiliated teaching hospitals in Toronto, Ontario. RESULTS: Over a 36-month period, 9,655 NG tube examinations were performed. Just over half of all exams (55.5%) required a single image for verification, while 10.1% required four or more images. The median time an MRT spent for an NG tube examination was 13.5 minutes, with 45.4% of exams completed in 10 minutes or less, while 4.5% required over 30 minutes. 118 incident reports and 57 survey submissions suggested five key CDPs; delayed verification, lack of verification, incorrect verification, increased radiation exposure, and inefficient workflow. CONCLUSIONS: CDPs associated with verifying NG tube placement can lead to poor patient care and inefficient workflows. The results of this study suggest that there may be value in future exploration of additional responsibility for MRTs as a potential solution for improving the NG tube process and thus patient care.