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BACKGROUND: Several techniques of nasogastric tube (NGT) insertion have been described in the literature with different success rates. AIM: To systematically search the literature and conduct a meta-analysis comparing the success rates, insertion time and complications associated with different techniques of NGT insertion in anesthetized and intubated patients. METHODS: An electronic search of the PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar databases were performed up to October 31, 2019. We included 17 randomized controlled trials with 2500 participants in the meta-analysis. RESULTS: As compared to the conventional method, successful insertion of the NGT on first attempt was higher with modified techniques such as the reverse Sellick's maneuver [relative risk (RR) 1.94; 95% confidence interval (CI): 1.62-2.31], use of a frozen NGT (RR 1.55; 95%CI: 1.13-2.13), inserting the NGT with neck flexion and lateral neck pressure (RR 1.64; 95%CI: 1.10-2.45), endotracheal tube-assisted (RR 1.88; 95%CI: 1.52-2.32) and video-assisted placements (RR 1.60; 95%CI: 1.31-1.95). All the modified techniques also led to comparatively higher insertion success rates than the conventional technique. CONCLUSION: The use of modified techniques of NGT insertion such as the reverse Sellick's maneuver, neck flexion with lateral neck pressure, frozen NGT, endotracheal tube-guided or video-assisted methods result in a significantly better chance of successful tube insertion at first attempt as compared to the conventional technique. All modified techniques also significantly improve the overall chance of successful NGT placement as compared to the conventional method.
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OBJECTIVES: To explore the current admittance situation of clinical teachers for masters of nursing specialist (MNS) postgraduates and to test the competence of clinical teachers in self-evaluation and other evaluations. METHODS: In this cross-sectional study, using a random number table, we chose 80 MNS postgraduates under clinical practice, their clinical teachers, and head nurses each from six hospitals in Hunan and Guangdong. The participants were tested on the basis of the Clinical Teachers' Competence Inventory of MNS Postgraduates. The competences of clinical teachers were evaluated by the three groups of participants. RESULTS: The aggregated scores of teacher competence as evaluated by the MNS postgraduates (181.33 ± 24.95) were lower than those assigned by both clinical teachers (190.75 ± 24.30) and their head nurses (198.53 ± 18.90), with significant differences in all dimensions except for clinical managing ability. The five highest rated items from all participants focused on the teachers' clinical nursing ability, and the five lowest rated items were mainly about their clinical research ability. CONCLUSION: The evaluation from MNS postgraduates is obviously lower than the self-evaluation of clinical teachers, and all participants are aware of the deficiency in research ability of the teachers. Thus, the admittance and examination of clinical teachers should be controlled strictly. Training should be carried out immediately to strengthen their comprehensive abilities, especially their research ability.