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Nursing Diagnosis & Midwifery 2018
S e p t e m b e r 1 0 - 1 1 , 2 0 1 8
P r a g u e , C z e c h R e p u b l i c
Page 80
Journal of Nursing and Health Studies
ISSN: 2574-2825
E u r o S c i C o n E v e n t o n
Nursing Diagnosis &
Midwifery
T
he placement of RIGs (Radiologically Inserted Gastrostomies) has been a common practice in the United Kingdom for more than
30 years and used as a strategy for long term feeding requirements. They are a well-established mean of supporting the nutritional
requirements of cancer patients who suffer, or are at risk, of dysphagia due to malignancy or cancer treatment. However, they are not
without risk. Following review of the RIG service, which identified major and unnecessary complications, a Lead Nurse for Gastrostomies
devices was appointed, with the aim of improving patient experience and to reduce complication rates. Subsequently, a service improvement
program (SIP), described below, was created and implemented in order to achieve that: update and development of policies and protocols;
development and implementation of a Gastrostomy Care bundle pathway; development of knowledge in gastrostomy care amongst nursing
staff via formal teaching sessions and by encouraging and motivating attendance; clinical assessment of patient and RIG care teaching,
within 24h following insertion, and via telephone clinic at week 1 and week 2; lead nurse who acts as a senior figure, ensures constant
provision of effective, high quality care, and is available for trouble-shooting, support and advice. Following implementation of the SIP, a
retrospective observational study over a two year period divided in two time points (Time 1– previous to SIP, Time 2–following SIP) was
done, showing: the overall incidence of complications decreased, and events such as bleeding or tube being inserted incorrectly, which are
considered serious and major complications, were not noted in Time 2, contrary to Time 1. The overall incidence of complications decreased,
specifically late complications, falling from 24% to 15%. The percentage of patients without any type of complications upto 30 days of post
insertion has increased from 74% to 83%.
4nurse@gmail.comThe impact of a service improvement program in a
well-established RIG service
Filipe Carvalho
The Royal Marsden Hospital, UK
J Nurs Health Stud 2018 Volume: 3
DOI: 10.21767/2574-2825-C4-012