47% of nasogastric tube never-events involve missed X-rays1
NHS Improvement classifies feeding through a misplaced nasogastric (NG) tube as a "never-event"2, and this is a subject of an ongoing patient safety alert3. X-ray confirmation of nasogastric tube placement is thought to be the most accurate method if a standard process is consistently followed. However, incorrect x-ray confirmation and interpretation is the most common cause of NG tube incidents. Research4 has shown that expected targets for competence in reporting of nasogastric tube position are not being met and require improvement.
In their December 2020 report, the Healthcare Safety Investigation Branch (HSIB) recommends that feeding tube X-rays be interpreted only by staff who have undergone competency training5.
The HSIB report also lists RAIQC as an example of good nasogastric tube placement training, as our package delivers training and assessment to clinicians, and also governance documents ready for adoption by organisations within and outwith the NHS in the UK and internationally too.
Our curated collection of cases provides a real-world study-list of nasogastric tube insertion chest X-rays, requiring reporters to review each X-ray before marking the position of the feeding tube and determining whether or not it's safe to feed the patient. This package focuses on the assessment of nasogastric tube position in adults (please adhere to your local policies regarding assessment in paediatric patients).
Upon completion of our nasogastric tube modules, reporting statistics are calculated, and certificates can be downloaded or shared so as to show competence in interpretation of nasogastric tube X-rays.
- Learn how to assess the safe positioning of nasogastric tubes on chest X-ray
- Hone your skills in a safe yet realistic simulated environment
- Test and evidence your ability with dedicated assessment cases
- Earn CPD points at your own pace
- Analyses of the Cause of Misplaced Nasogastric Tube Never Events
- NHS Improvement Never Events policy and framework
- NHS Improvement: Patient Safety Alert: Nasogastric tube misplacement: continuing risk of death and severe harm.
- Chest X-ray Confirmation of Nasogastric Tube Placement: Radiographer Responsibility
- Placement of nasogastric tubes. Independent report by Healthcare Safety Investigation Branch
This package includes the following modules:
Nasogastric Tube on CXR - Educational content
Learn how to differentiate between correctly and incorrectly positioned nasogastric tubes.
Nasogastric Tube on CXR - Training cases
Practise on a series of real-world cases to determine correct positioning of nasogastric tubes, receiving immediate feedback for each case.
Nasogastric Tube on CXR - Assessment cases
A collection of chest X-rays to test your skills at spotting correct or incorrect NG tube positioning, with your overall accuracy calculated upon module completion.
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- Nasogastric Tube on Chest X-ray
Created 21 April, 2023
Last updated 1 September, 2023
Module types included:
- Educational content 1
- Training 1
- Assessment 1
- Training and assessment cases 45
- CPD points available 3