Adult Branch 4
Promoting Integrated Care
This essay will discuss and critically analyze a nursing intervention used in practice placement. Discussion will include the knowledge underpinning practice and the evidence base for the clinical intervention. It will examine what the evidence base states should happen and what actually happened in practice. The clinical intervention chosen to reflect on within this essay is care of a patient requiring feeding via a nasogastric (NG) tube due to dysphagia.
This is a condition in which the action of swallowing is difficult to perform (Royal Marsden, 2008). It is important to note that all confidential information relating to patient, ward, hospital and professional colleagues has not been included in this paper to ensure ethical practice and adherence to the NMC code of professional conduct (NMC, 2008). This nursing intervention was essential for a patient in my care, who for the purpose of the essay will be referred to as Sylvia.
Nasogastric tubes are used as a short or medium term nutritional support and also for aspiration of stomach contents (Royal Marsden, 2008). Food can be administered through the tube directly into the stomach and the swallowing process does not need to take place. The food is administered by a pump that controls the amount of feed given in mls per hour.
Sylvia was admitted to the ward following a CVA. She required enteral tube feeding via an NG tube as an immediate intervention and would later be assessed to see if she was a suitable candidate for a percutaneous endoscopic gastrostomy (PEG) tube which are used as a more permanent form of enteral tube feeding (Holmes 2004).
The nasogastric tube is a narrow bore tube about ‘22 inches [55.9cm] in length’ (Holmes, 2004). The positioning of the patient is the first area to look at. Positioning of the patient is important on insertion of the tube, the...