Nasogastric and Nasoenteric Tube-Related Incidents: A Cohort Study with Hospitalized Brazilian Older Adults.

Abstract

Aim: The natural aging process, aggravated by the presence of disease and other factors, makes older adults more susceptible to the need for nutritional therapy. Patient safety is a worldwide concern, and older adults are one of the age groups at risk for incidents, especially related to the use of nasogastric and nasoenteric tube feeding.

Methods: This prospective cohort study aimed to identify and analyze incidents related to the use of nasogastric and nasoenteric tubes, their consequences, and the associated factors in hospitalized older adults. The study was carried out in a public general hospital in the state of São Paulo. Data were collected between October 2016 and November 2017 for this study, and continued until April 2019 in other hospitals involved in the "Multicentre study" through voluntary reporting by healthcare providers, patients or their companions, active searches during ward visits, and reviews of medical records.

Results: The sample consisted of 86 older adults, with a mean age of 71.33 years, high nursing care dependence (39.53%), and a high risk of death (59.30%). The primary reason for tube use among older adults was sensory decline in health (31.40%), followed by lack of appetite and poor oral diet acceptance (22.09%). The most common insertion technique was blind bedside insertion (45.35%), with gastric positioning being the most frequent (44.18%), according to patient records. The prevalence of incidents was 43.02%, among these 35.14% older adults experienced only one incident, 18.91% had two incidents, and 45.95% had three or more incidents. The unplanned removal of the tube was the most frequent event (28.71%), and 56.44% of the cases resulted in mild harm. The death of older adult patients using NGT/NET was not associated with age, sex, level of consciousness, level of nursing care dependence, risk of death, length of monitoring, length of hospital stays, or total incidents.

Conclusion: The level of nursing care dependence and age were associated with the occurrence of incidents, highlighting the urgent need to adopt protocols based on updated scientific evidence to guarantee quality and safe care for hospitalized older adults.