What Is the Evidence to Support Ongoing Nasogastric Tube Position Testing? A Prospective Observational Study of Adverse Events in Australia and the United Kingdom.
Kate Glen, Christine Elizabeth Weekes, Merrilyn Banks and 1 others
PMID 39925209WHAT IT FOUND
Nasogastric tube pH tests failed more often than length checks, and the hospital requiring pH plus length checks had more X-rays and missed feeds or medications.
One false pH result missed a displaced tube that led to aspiration pneumonia.
Key findings
01pH testing was much more likely to be unsuccessful than external tube length measurement alone.
02London, whose guideline required pH testing and external length checks, had more X-rays and more disruptions to feeds or medications than Brisbane, whose guideline required external length checks alone.
03One false pH result missed a displaced tube that was used, and the patient developed aspiration pneumonia.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The hospitals were chosen for their different testing guidelines, and patients were not randomly assigned to methods, so differences may reflect local practice rather than the test itself. Data came from medical records, and documentation may have been poor, scattered, or copied from earlier entries, so some tests or results may have been missed. London and Brisbane data were collected at different times, which may have introduced differences unrelated to testing method. Tube displacement was rare, so the study cannot reliably compare safety between methods. The study included only adult nasogastric feeding tubes and excluded other tube types or decompression-only tubes, so it may not apply to all patients.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that pH testing caused all the extra X-rays and missed feeds, or that external length checks are proven safer. The hospitals followed different guidelines, had different patient groups and feeding regimens, and patients were not randomly assigned to testing methods.