Interventions for maintaining nasogastric feeding after stroke: An integrative review of effectiveness and acceptability

Mahoney, Catherine; Veitch, Linda

Abstract

Aims and objectives
To investigate the effectiveness and acceptability of interventions for maintaining nasogastric tubes (NGT) in adult stroke patients.
Background
Internationally, incidence of Cerebral Vascular Disease (CVD) continues to increase and stroke is the largest cause of complex disability in adults. Dysphagia is common following a stroke which necessitates feeding via a NGT. NGT are not well tolerated by stroke patients and may be frequently dislodged. Hence, interventions such as tape, the nasal bridle/loop (NL) or hand mittens (HM) may be used to maintain NGT position. However, evidence around the effectiveness and acceptability of these interventions has not been reviewed and synthesised.
Design
Integrative literature review.
Method
Database searches in MEDLINE, PubMed, CINAHL, Scopus, Cochrane and EMBASE; manual reference list searches.
Results
Seven studies met the eligibility criteria and were included in the review. Evidence for the effectiveness of NL and HM to maintain NGT position in patients after a stroke is spare and methodologically poor, and especially limited around HM use. There is insufficient evidence about the acceptability of both NL and HM among stroke patients.
Conclusion
Current clinical practice is underpinned by assumptions around the acceptability of NL and HM to secure NGTs. This results in reliance on consensual judgement between professional, patients and their families to guide their use among individuals with dysphagia after stroke. Further research is required to assess the effectiveness of HM and acceptability of both NL and HM among stroke patients to inform guideline development.

Citation

Mahoney, C., & Veitch, L. (2018). Interventions for maintaining nasogastric feeding after stroke: An integrative review of effectiveness and acceptability. Journal of Clinical Nursing, 27(3-4), e427-e436. https://doi.org/10.1111/jocn.14013

• Journal Article Type: Article
• Acceptance Date: Jul 31, 2017
• Online Publication Date: Aug 9, 2017
• Publication Date: 2018-02
• Deposit Date: Aug 9, 2017
• Publicly Available Date: Aug 10, 2018
• Journal: Journal of Clinical Nursing
• Print ISSN: 0962-1067
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 3-4
• Pages: e427-e436
• DOI: https://doi.org/10.1111/jocn.14013
• Keywords: Stroke; dysphagia; feeding; nasogastric tube; restraint; acceptability; nursing.; nasal loop; hand mittens
• Public URL: http://researchrepository.napier.ac.uk/Output/974201