NG Special interest group (NGSIG) is a special interest group within BAPEN. This multidisciplinary forum for professionals aims to review national and local data including approaches in managing nasogastric tube therapy for the purpose of providing nutrition, hydration and or medication; for example NGT Never Events, policies, protocols and resources.
The NGSIG will also provide an opportunity for members to raise awareness of NG safety, debate complex issues and advance practice by collaborative working, research, audit, and engagement with industry.
Members include a core group of BAPEN members who have a special interest in NG to a maximum of 12 members. Members may wish to nominate a deputy to attend meetings on their behalf these representatives must also be a BAPEN member and have the equivalent special interest knowledge and skills within NG field. Where the public or staff working with patients/family wish to raise important issues relating to NG safety, the group will be accessible via email. Anyone wishing to contact the group will be expected to outline the issue and questions required to be addressed via the NGSIG email inbox firstname.lastname@example.org. This will be received by the group, considered by the committee, and where appropriate share the issue and the committee’s response via the member’s forum under the frequently asked questions section (FAQ). It is anticipated that the committee will meet at least 3 times a year but may increase in frequency should important NG concerns arise.
BAPEN members will be regularly updated on the work of the NGSIG via this page. We always welcome and actively encourage new committee members to join us to experience and actively participate in the work that the committee undertake. If you are interested in joining the NGSIG committee, email: email@example.com outlining your commitment, alongside any skills/knowledge and experience within the arena of NG.
- To provide a multi-professional forum enabling discussion on best practice between those health professionals in the UK who provide Nasogastric (NG) therapy (for the purpose of feeding, fluids or medication) to adults and children.
- Through communication and facilitation of research and audit, the group will foster excellence within the UK in the provision of NG therapy (in the context of managing clinically assisted enteral nutrition/hydration/medication). Excellence of care should include all aspects of Nasogastric tube (NGT) safety and usage.
- To foster, develop and support BAPEN core groups to assist health professionals in the management of NG therapy.
- To assist BAPEN and other external organisations where appropriate in reviewing matters relating to NG therapy (in the context of managing clinically assisted enteral nutrition/hydration/medication).
- To assist in the development of consistent best practice across the UK for activities related to NG therapy. This might include guideline development, setting up a communications network for support and advice amongst its members, and support relevant audit and research activities.
- To support the educational meetings of interest to its members which may have educational, audit, or scientific content.
- To liaise with other national bodies such as NNNG, PINNT, BDA, RCSLT, NHSE/I and HSIB to further the safety of NGT therapy.
- Membership of the group will be open free of charge to any health professional who has an interest in NG therapy and who is a member of BAPEN
- The group will be a deemed a Special Interest Group within BAPEN, and therefore will adhere to the BAPEN Constitution.
- The group will appoint a Chair and an honorary secretary. These roles will be elected by the NGSIG group every 2 years according to the committee’s needs. The chair will represent NGT therapy on BAPEN council
- The group will hold regular in person or virtual meetings to support its aims and objectives (Quarterly meetings).
- The activities of the group will be reported to the BAPEN Executive Committee and to Council by the Chair of the committee.
- Finances: Expenses incurred by Committee members will be reimbursed by BAPEN following receipt of an expenses claim form. Meetings of the group will be organised in line with BAPEN guidelines and all costs involved recorded in the BAPEN accounts.
Exclusions from ToR:
- Use and safety of nasogastric tubes used solely for drainage purposes (Drain/Ryles tubes) except where common ground can be identified.
Dr Barry J M Jones Bsc, MBBS, MD, FRCP. Consultant Gastroenterologist (Retired). Trustee of BAPEN and Chair of BAPEN IAC., Chair, AGP Alliance
Wendy-Ling Relph: Clinical & Service Lead: Nutrition & Hydration, East Kent Hospitals University NHS Foundation Trust.
Dr Stephen Taylor PhD: Critical Care and Research Dietitian, North Bristol NHS Trust
Linda Broomfield, Lead CNS Nutrition, Hywel Dda University Health Board
Suzy Cole, Clinical Practice Manager at Nutricia, Committee member NNNG
Emma Sykes, Stroke and Nutrition Support Dietitian
Rosie Smyth, Nutricia Nurse
Mairi Pedersen, Nutrition Specialist Nurse, Epsom and St Helier University Hospitals NHS Trust
Oscar Walton, Specialist Renal Dietitian, Nottingham University Hospitals
NGSIG Group Entry requirements:
- Member of BAPEN
- A healthcare professional involvement in NGT care (indication, positioning and confirmation, NGT care and use) in both adult and paediatric populations.
- A passion and enthusiasm advancing NGT practices and policies.
Members of NGSIG would be expected in contribution and involvement in the following:
- Develop consistent best practice for NGT therapy within the UK through the production, communication, and discussion of NGT related research, audits, and guidelines development.
- Engage in quarterly to discuss activities of the group and areas relevant to the group aim: achieving consistent best practice for NGT therapy across the UK.
- Engage in a communication network to support members with relevant audit and research activities, and guideline development.
- Support other BAPEN core groups and healthcare professionals in NGT therapy management. Members are encouraged to liaise with other professional groups such as NNNG, BDA, PINNT, HSIB, NHSE to support consistent best practice.
Membership is free of charge and members will elect a chair and honorary secretary every 2 years. The chair will represent NGT therapy on the BAPEN council, highlighting the groups activity to the BAPEN council and disseminating feedback back to the NG-SIG group.
This group encourages all healthcare professionals with an enthusiasm for promoting and advancing NGT care practices to apply. It is an excellent opportunity to represent your professions input with NGT care and support innovation within this field.
Members of the NGSIG Committee
- Wendy-Ling Relph: Clinical & Service Lead: Nutrition & Hydration, East Kent Hospitals University NHS Foundation Trust
- Dr Barry Jones MD, FRCP: Consultant Gastroenterologist (Retired) Dudley Group of Hospitals NHS Foundation Trust
- Liz Anderson Nutrition Lead Nurse, Bucks Healthcare NHS Trust
- Paula Edwards: Lead Nutrition Nurse Specialist, BCUHB, North Wales
- Gill Murray-Ashby: Nutrition Nurse Specialist, Darent Valley Hospital
- Dr Stephen Taylor PhD: Critical Care and Research Dietitian, North Bristol NHS Trust
- Linda Broomfield: Lead CNS Nutrition, Hywel Dda University Health Board
- Suzy Cole: Clinical Practice Manager at Nutricia
- Emma Sykes: Stroke and Nutrition Support Dietitian, Wye Valley NHS Trust
- Rosie Smyth: Nutrition Nurse Specialist, Belfast Health and Social Care Trust
The purpose of this document is to provide a brief overview and assessment of novel tech devices available for guided tube placement, including: their purpose, efficacy, training provided, training required, ability to confirm tube position, logistics and NHSI status. This will help standardise practice nationally as well as support and encourage new operators, including dietitians, to confidently complete competency training in guided tube placement. Longer-term this will contribute to placing enteral tubes safely and effectively, improve the quality of currently available devices, and provide opportunities for advancing dietetic practice.
Literature review and assessments
A literature review was conducted by the CCSG NJ team, to present and critically appraise existing evidence on the use of the two main guided tube placement systems (CortrakTM [Avanos] & IRIS® [Cardinal Health]) [see supplementary material for full literature search].
A detailed assessment is presented for each system, which provides a general overview of publications to date, including data on gastric and post-pyloric placements as well as respiratory misplacements. Evidence is graded based on three criteria (a – evidence from clinical studies; b – scientifically sound; c – author independence). Manufacturer guidance and competency assessments currently available for each system are also reviewed and graded against three further criteria (a – accurate; b – comprehensive; c – evidence-based) with justifications. Finally, each system’s logistics (bedside; cheap; quick; simple) as well as ability to confirm different anatomical points within the respiratory and gastrointestinal tracts are assessed. Ability to confidently identify anatomical markers using each bedside system is graded as yes/no/partial.
Based on the assessments and expert opinions of the CCSG NJ and BAPEN NG-SIG teams, recommendations are made on the level of training (number of placements) required for new users to achieve competence and expertise as a solo operator and trainer.
The novel tech assessments were peer-reviewed by multiple members of the NG-SIG and CCSG teams, and these were also sent to the manufacturers. Amendments and revisions were undertaken based on comments provided. The assessments will be reviewed annually, or earlier as required depending on new evidence or significant changes in training guidance released by the manufacturers.
We would like to thank the wider BDA CCSG and BAPEN NG-SIG teams for their useful contributions to this document and for making publication possible.
If referencing this document, please cite as below:
Taylor SJ, Karpasiti T, Milne D; on behalf of the British Dietetic Association (BDA) Critical Care Specialist Group (CCSG) NJ team. Guided Tube Placement Novel Tech Assessments. BDA CCSG; 2022. https://www.bda.uk.com/specialist-groups-and-branches/critical-care-specialist-group/guided-tube-placement/guided-tube-placement-novel-tech-assessments.html
Disclaimer: BAPEN Position Statements/Guidelines have been prepared as guidance only to assist qualified healthcare professionals in the decision making processes surrounding nutritional care. Users of these materials may only do so on the condition that they exercise their own professional knowledge and skills when applying such guidance to specific circumstances. Anyone without the appropriate qualifications must seek the advice of a qualified healthcare professional before taking, or refraining from, any action on the basis of the policies or guidance. BAPEN does not (i) owe a duty of care to users of the policies or guidance who are not qualified healthcare professionals; and (ii) cannot accept liability to anyone using these policies or guidance.
For further information
- NGSIG Position Paper “Time to put patient safety first” – September 2020
- BAPEN Principles of Good Nutritional Practice on NG Tube Insertion – currently being updated
- NNNG Good Practice Guideline on the Safe Insertion and ongoing care of Nasogastric Feeding Tubes in Adults
- NHS Never events data
- Healthcare Safety Investigatory Branch (HSIB)
Should you have any topics you would like the NGSIG to discuss please email NGSIG firstname.lastname@example.org.