Title : Effect of a multimodal infection control programme in the reduction of bacterial contamination in the nasogastric feeding tube hubs in residential care homes for elders
Abstract:
Nasogastric tube (NG tube) feeding in residential care homes for the elderly (RCHEs) carries the risk of contamination at the NG tube hub, a crucial connection point in the enteral feeding process. This contamination can lead to the spread of harmful microorganisms, potentially resulting in serious complications such as mortality. However, there is limited research on the effectiveness of infection control programs (ICPs) in reducing NG tube hub contamination.
This study aimed to assess the impact of a comprehensive ICP on reducing bacterial contamination in NG tube hubs, enteral milk, and the hands of RCHE staff, while also evaluating its effectiveness in enhancing the staff's knowledge and skills in NG tube feeding. The research utilized a single-blinded cluster-randomized controlled trial involving eight RCHEs. The intervention group received a 12-week multimodal ICP, including educational sessions on infection control measures related to NG tube feeding, while the control group did not receive this intervention.
The ICP sessions, which involved various teaching methods such as PowerPoint presentations, videos, group discussions, and practical workshops, were tailored to accommodate the staff's shift schedules. Bacterial samples were collected from residents' NG tube hubs, enteral milk, and staff's fingertips for analysis. Pre- and post-intervention data on NG tube feeding knowledge and skills were also gathered and compared between the two groups.
Eight RCHEs with 140 residents and 250 RCHE staff participated in the study. Results showed a significant reduction in the total bacterial counts of the NG tube hubs within the intervention group before and after the intervention (p=0.04), as well as between groups (p=0.001). Both groups had 19 contaminated NG tube hubs at baseline. After intervention, the number of contaminated NG tube hubs was reduced to 13 in the intervention group but no changes were found in the control group. In addition, the total bacterial counts of the enteral milk was significantly reduced between groups (p=0.001) while there was no enteral milk contamination in either group before and after intervention.
The knowledge and skills in NG tube feeding was increased significantly in the intervention group (p=0.001) and was significantly improved compared with the control group after intervention (p=0.001). There were significant reductions in the total bacterial counts in right and left fingertips of the RCHE staff of the intervention group within group (p=0.001) and between groups (p=0.001) after intervention. Also, the number of fingertips contaminated was significantly reduced within the intervention group (p=0.001) and between groups (p=0.001). These findings underscore the effectiveness of the multimodal ICP in minimizing bacterial contamination and enhancing infection control practices in NG tube feeding.
In conclusion, the study highlights the positive impact of the ICP on reducing bacterial contamination in NG tube hubs and promoting proper hand hygiene among RCHE staff. Continuous implementation of such programs in RCHEs is recommended to sustain and further improve infection control practices in NG tube feeding.
