The HSIB report clarifies that current testing methods for NGT position are significant contributors to NGT Never Events, noting that;
“…both pH testing and use of X-ray are prone to error…”
“…using pH testing strips is potentially unreliable and its complexity underestimated…”
“The investigation also identified concerns about the reliability and usability of pH strips.”
“There is no standard process on how to read a pH strip.”
“In two of the Never Event reports, the nursing team was not able to get any aspirates for pH checks…These scenarios are common…”
“The environment within which pH testing strips are being interpreted can increase the risk of error. In the reference event, this was particularly noted with the poorly lit environment.”
“…causes included misinterpretation of pH testing of gastric aspirate, use of outdated checking methods use of outdated checking methods…”
“…incorrect X-ray confirmation and interpretation is the most common cause of NG tube incidents.”
“…misinterpretation of X-rays by medical staff was the most common cause of placement errors.”
NGPOD either overcomes or significantly reduces many of the factors identified as contributing to Never Events related to the use of misplaced NGTs.
NGPOD is a handheld bedside test of pH that fits into current guidelines and patient pathways as a 1st line pH test, replacing the need to obtain gastric aspirate and the use of pH strips.
NGPOD is used for initial NGT insertion and repeats checks, which means clinical staff use the same NGT placement confirmation test regardless of the use situation.
NGPOD works with any nasogastric tube that is 6FR or above. This compatibility with all manufacturers NGTs means that clinicians do not need to change any other part of their NG feeding system or clinical pathway to implement NGPOD.
NGPOD has completed its multicentre clinical trial and is as reliable as existing methods and;
• Provides a pH test result significantly more often than aspirate and pH strips
• Gives a result more rapidly than aspirate and pH strips, reducing clinical staff time to complete the test and staff exposure time to patients
• Gives a clear pH </= 5.5 Yes/No result with no need for user interpretation
• Does not require aspirate to be obtained
• Is very easy to learn to use
• Reduces the need for x-rays reducing patient exposure, reduces the risk of misinterpretation of x-rays and resource demand in radiology
• Reduces delays to patients receiving their prescribed nutrition, hydration and medication, which may improve recovery
Based on the data from the NGPOD Multicentre trial NGPOD is less expensive than existing methods of NGT placement confirmation due to the reductions in staff time to perform the test and the reduction in x-rays. Based on the results of previous clinical studies showing that aspirate cannot be obtained in up to 45% of attempts (Borsci, 2018), it is likely that in real-world situations, the cost savings will be even more significant than those shown in the NGPOD trial.
Given the additional difficulties in using pH aspirate and pH strips when donning and doffing PPE continuously while caring for Covid 19 patients, NGPOD may offer significant advantages by reducing time to test because of the removal of the need to obtain aspirate and the need to interpret the result of a pH strip. Reduction of x-rays may also reduce the number of clinical staff exposed to patients.
NGPOD Global fully support healthcare organisations through the evaluation and implementation of the NGPOD system. In April 2021, the NGPOD training App will be launched, providing support on-demand in clinical settings and a certification process for operators that clinical leaders can monitor.
NGPOD is available from NHS Supply Chain in England on the enteral consumable’s framework and direct from NGPOD Global, making it easy for any UK healthcare organisation to adopt.
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