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

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-11-01 Epub Date: 2025-07-16 DOI:10.1016/j.amjsurg.2025.116522

Anna J Kobzeva-Herzog, Maia R Nofal, Jacob Bodde, Sophia M Smith, Pamela Rosenkranz, David Guez, David McAneny, Jeffrey J Siracuse, Aaron Richman

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引用次数: 0

Abstract

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.

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实施质量改进倡议减少了成人住院病人胃造口管移位。

背景：我们研究了一项旨在预防急性住院病人胃造口管（g管）移位的质量改进计划的成功。研究设计：这是一项回顾性队列研究，纳入了≥18岁的住院成人患者（2021年9月- 2023年8月）。2022年9月实施了新的护理令和修订的护理教育，其中规定了标准化的g管护理。比较干预前和干预后g管脱位的发生率。结果：555例g管放置，其中236例发生在干预后。实施一年后，合规率为71.2%。接受新手术的患者比没有接受手术的患者有更少的脱位（8.3% vs 29.4%, P < 0.001）。多变量分析表明，使用顺序与脱位风险降低相关（OR 0.51, CI 0.28-0.99, P = 0.046）。结论：多学科的举措可以减少并发症的可能性，改善患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.