Incidence of Nasogastric Tube-Related Pressure Injuries in Intensive Care Unit and Internal Medicine Ward.

Abstract

Background: Incidence data for medical device-related pressure injuries caused by nasogastric tubes are limited. Rates may be higher in intensive care units (ICUs) than internal medicine wards because of the increased vulnerability of ICU patients.

Objective: To determine incidence and contributing factors of nasogastric tube-related pressure injuries among ICU and internal medicine ward patients.

Methods: This prospective cohort study included adults admitted to the ICU or internal medicine ward with a nasogastric tube placed during or within 4 hours before admission. Patients with facial injuries, wounds, or ulcers were excluded. Patients were monitored daily for nasogastric tube-related pressure injuries; location and stage of pressure injuries were documented.

Results: Data were collected July 2022 to July 2024 in the ICU (88 patients) and internal medicine ward (48 patients) of a 900-bed general medical center. The nasogastric tube-related pressure injury incidence was significantly lower in the ICU (4 patients; 0.47 per 100 patient-days) than in the internal medicine ward (13 patients; 3.02 per 100 patientdays) (P < .001). Charlson Comorbidity Index was higher in internal medicine ward patients than ICU patients (mean [SD], 7.7 [2.39] vs 3 [2.41]; P = .02). Nasogastric tube fixation methods differed between departments.

Conclusions: Unlike previous reports, nasogastric tube- related pressure injury incidence was higher in the internal medicine ward than the ICU. Possible contributors include comorbidity burden, nurse to patient ratios, and nasogastric tube fixation techniques. These confounding variables warrant further investigation.