Introduction: A quality improvement project was implemented at an academic teaching hospital, where 105 percutaneous endoscopic gastrostomy (PEG) tubes were placed from February 2024 to February 2025, and five were dislodged. A 4.76% dislodgement rate. Possible complications after PEG tube insertion include dislodgement, infection, peritonitis, and GI bleed. Implementation of an educational program focused on improving compliance with the hospital's standard of care.
Methods: The aim was to reduce inadvertent dislodgement within a 14-day postoperative period. This project included pre- and post-education surveys of nursing confidence and patient observations for compliance. Nurses from the Neurotrauma ICU and PCU, the Surgical ICU and PCU, and one medical-surgical unit participated in education. Patient participation included adults over 18 years with a new PEG tube placed within the last 14 days on the five units. Patients with a PEG tube placed prior to hospitalization were omitted.
Results: The final results showed that 78.8% of nursing staff were educated, and 55.1% of staff had increased comfort in caring for patients with PEG tubes and abdominal binders. After implementation, abdominal binder placement increased 61.9% (p= 0.001); correct binder placement increased 47.6% (p= 0.005). Dressing compliance increased 52.4% (p= 0.002). Binder documentation increased 23.5% (p= 0.133). Binder orders increased 9.5% (p=.523). During these 3 months, 0 PEG tubes were dislodged, which may be coincidental or a correlation to the intervention.
Conclusions: A longer study time is needed to assess the correlation between education and decreased dislodgement.
