Wednesday 28 February 2024
Salisbury Foundation Trust

FOI_6636

Internal Reference Number: FOI_6636

Date Request Received: 15/06/2022 00:00:00

Date Request Replied To: 04/07/2022 00:00:00

This response was sent via: By Email

Request Summary: Investigation into nasogastric tubes

Request Category: Companies

 
Question Number 1:
Can you please confirm with the RIS/PACS team if the Trust have implemented the recommendations set out by the NPSA and reinforced in the HSIB report for X Ray reporting? Yes or No

Description / additional information:

The NPSA1 and the recent HSIB investigation into nasogastric tubes2 have reinforced the need to have clear and transparent reporting for X ray requests and interpretation of nasogastric tube placement.

“X-ray checking procedures must be timely and carried out by clinicians assessed as competent to do so. All results should be confirmed and recorded in the patient record ensuring the most current x-ray for the correct patient is reviewed, the four criteria for confirming gastric placement and clear instructions as to actions required are documented using a structured approach and communicated to the relevant nursing staff”.

There is limited flexibility within the National Interim Clinical Imaging Procedure (NICIP) Code set and may require the PACS team to capture the inputs in the free text fields.
 
Answer To Question 1:
All CXRs are formally reported by Radiologists, so we have not had to implement any of the suggested recommendations
 
Question Number 2:
Can you please confirm the number of “Plain Film Chest X-Ray” requests (XCHES) where a nasogastric tube / NG tube was specified as free text in the clinical indication field or requested as “XR Nasogastric tube position” (XNASG) for the period from April 1st 2021 to March 31st 2022?

Number of cases reported for:
XCHES + free text
XNASG
Other

Pls provide the total
 
Answer To Question 2:
The XNASG code has never been used at this hospital and is not used by the other Trusts within our PACS network
There are a total of 219 Chest X-Rays requested in that year that contain free text relating to NG tube placement checks
 
Question Number 3:
Based on the response to Q2 can you please confirm if the reason for the request was captured: confirmation of 1st placement, suspected dislodgment / displacement of established nasogastric tube or simply not reported in the clinical indication field?

(This may include the SNoMED codes: Migration Of Nasogastric Tube (Disorder) 473160008)

Pls provide breakdown of information as per below:

Number reported for:

1st Placement
Dislodgement / Displacement
Not reported
 
Answer To Question 3:
Request tend to be generic “NG placement” checks, not stating first placement / dislodged
 
Question Number 4:
Based on your response to Q3 can you please confirm if the site of the nasogastric tube was reported and the overall number with specific attention to the lung or oesophagus or in the stomach and safe to feed?

Pls provide the breakdown of information as per below:

1st Placement
Safe to feed -Tube in stomach =
Do not feed -Tube in lung =
Do not feed - Tube in oesophagus =
Not reported =

Dislodgement / Displacement
Safe to feed -Tube in stomach =
Do not feed -Tube in lung =
Do not feed - Tube in oesophagus =
Not reported =

Not stated
Safe to feed -Tube in stomach =
Do not feed -Tube in lung =
Do not feed - Tube in oesophagus =
Not reported =
 
Answer To Question 4:
Set templates are not in use for NG checks. We are unable to provide an answer to question 4 as we do not have the ability to count free text stats from reports without manually checking.
 
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