Cumbria Crack

CQC report finds nasogastric tube management to be safe at north Cumbria’s hospitals

[A] report published by the Care Quality Commission (CQC) has found the insertion and management of nasogastric tubes are ‘safe, effective and well-led’ at North Cumbria University Hospitals NHS Trust.

The CQC carried out a focussed inspection at the Trust in July 2017 following the findings of Her Majesty’s Coroner after an inquest in January 2017 into two patient deaths relating to misplaced nasogastric tubes.

The inspection took place across medical, surgical, paediatric and intensive care wards at the Cumberland Infirmary in Carlisle and West Cumberland Hospital in Whitehaven. The team also checked the Trust’s progress with delivering the action plan in response to the coroner’s concerns.

The Trust set out a clear action plan, led by medical director Dr Rod Harpin, to ensure that staff training in nasogastric tubes was improved, and policies and procedures were clear and well defined.

The inspection team’s findings included:

  • Staff assessed the needs of patients and delivered care in line with existing policies. Procedures were also compliant with national best practice guidance
  • There had been no serious incidents regarding nasogastric tubes since April 2015
  • Clinical staff involved in the insertion of a nasogastric tube were now required to complete mandatory training
  • Clear processes were in place to manage the progress of the action plan developed in response to the coroner’s concerns

The report also highlights improvements made in the reporting of incidents or near-misses and that staff were fully supported to attend meetings where feedback and learning was encouraged.

Tube insertion verification can only be done by experienced doctors who have completed the required learning. The Trust’s radiology department is also prioritising X-rays where the request is to confirm the position of a nasogastric tube.

The report has also highlighted some areas where the Trust can further improve including developing a specific policy for the use of nasogastric tubes for pregnant women.

Commenting on the report, Dr Rod Harpin, medical director at North Cumbria University Hospitals NHS Trust, said: “We have rightfully spent a lot of time reflecting on the learning for the whole organisation following the deaths of two of our patients in order to ensure this does not happen again.

“We are pleased that the CQC has recognised the amount of work the Trust has undertaken in order to improve our nasogastric care management, processes and policies. However, the work does not stop here and all of our staff are committed to continuing to make further improvements in safety for our patients.”