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A nurse-led trial has found that a new electronic tool could reduce the number of preventable injuries and deaths caused by wrongly inserting nasogastric tubes. The study, led by Tracy

Earley, a consultant nutrition nurse at Royal Preston Hospital, tested a new fibre-optic device which can tell clinicians definitively if a nasogastric tube – which is inserted through the

nose and delivers food, hydration and medicine into the stomach – has been placed correctly. > “Nurses are on the front lines and are the ones who actually > insert these tubes"

>  > Tracy Earley Currently, to check if nasogastric tubes – also referred to as NG tubes – are in the right place, nurses have to extract bodily fluid from the patient through the

tube. Clinicians then test this fluid on a pH strip to judge whether the placement is correct. Studies show that interpreting the pH level results in mistakes 12-30% of the time, and that in

46% of cases nurses are unable to draw aspirate at all. This means patients have to undergo x-rays, leaving them without nutrition or treatment for longer. The study tested a device called

NGPod, which uses a fibre-optic sensor to retrieve the pH reading from the tip of the NG tube leading to a definitive 'yes' or 'no' result in terms of whether it has been

placed correctly – removing the need for aspirate or interpretation from the health professional. The clinical trial, which has been published in the journal _BMJ Nutrition, Prevention

& Health_, was conducted on 154 adult patients across three NHS secondary care sites. It found that the device was as accurate as pH strip testing, and removed all of the risks

associated with making subjective pH strip judgements. The study concluded that: “Further research and acceptance studies involving greater numbers of subjects and study centres may be

necessary before adoption in the NHS”, but that using the tool “in clinical practice could transform [nasogastric tube] position checks”. Incorrect nasogastric tube placement is the UK’s

fourth most common cause of ‘never events’, the NHS’s term for serious preventable incidents. The number of these incidents has soared over the last decade; in the last financial year there

were 31 incidents caused by wrongly placed tubes, compared to 16 in 2013-14. Tracy Earley Ms Earley has spent years working with UK health start-up NGPod Global to improve nasogastric tube

products and processes. She previously led on an innovation that involved fitting the nasogastric tube with a radiopaque tip so that the end could be seen on an x-ray. “That wasn’t on the

market at the time,” she told _Nursing Times_. “I'd been banging on about this for a long time, and I managed to get NGPod interested. “The company’s managing director wasn't from

a clinical background, and couldn't really understand the need. “So, I told him, ‘You’ve got to experience having an NG tube inserted yourself’. He did it, in good spirits, and then he

understood the need.” After the team developed a radiopaque tube, Ms Earley came back with a new idea. She said: “I thought about how blood glucose levels used to be monitored with colour

changing strips, and now we use blood glucose machines. “I thought, if we managed that evolution, why couldn't they do the same around NG tubes?” She added: “Nurses are on the front

lines and are the ones who actually insert these tubes. “We know that we need to make it as easy as possible to get the right treatment for patients. “Having a ‘yes’ or ‘no’ response means

patient safety is improved, and patients can get access to medications and feeds quicker, which makes organisations more efficient too.” Ms Earley highlighted that the tool could also

improve the experience of nurses, 30-50% of whom admit pH strip testing causes anxiety. She said: “Sometimes the changes between colours on pH strips are quite discreet, they might even

differ between different pH strip brands. It really can cause a lot of anxiety. “Devices like NGPod remove that pressure, reducing the risk of misreading pH tests and decreasing the need for

x-rays.” The company behind NGPod said that, since the study, the device was now being used in 12 hospitals, and was set to be rolled out in a further six NHS trusts in the next few months.