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Recommended Citation
Jachymiak R. Nasogastric/Orogastric Verification: pH or Not to pH?. Evidence Based Practice poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Evidence Based Practice poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Background/Introduction:
Review of current literature identified pH testing as superior to air insufflation for verification of Nasogastric/Orogastric placement in pediatric patients 28 days and older. X-ray is considered the gold standard but not practical. The practice of auscultation has risk of incorrect placement, which can have negative patient outcomes if you introduce formula or breast milk into the lungs.
Purpose:
The purpose of this initiative was to implement best practice for Nasogastric/Orogastric placement verification in infants and children 28 days and older to prevent safety events associated with incorrect placement.
Implementation plan:
With this information, a suburban children’s hospital identified the opportunity to improve patient safety through the implementation of pH verification for Nasogastric/Orogastric placement. This evidence-based practice initiative was implemented in October 2022. The pH verification initiative was implemented across two campuses (8 units) of the Children’s Hospital. A workgroup was formed, and unit champions were identified within each pediatric unit. Nurses were educated by reviewing guideline changes and completing a voice-over PowerPoint. Once the education was completed, unit champions completed a hands-on return demonstration with each nurse. The team worked with Clinical Informatics for the pH results to be built into the Electronic Medical Record. The team worked with Supply Chain to order and stock the necessary supplies for pH testing. The workgroup created educational tools for post-implementation. Post-implementation data was collected and PDSA cycles were utilized to increase practice adoption in all units.
Outcomes:
Post-implementation data shows improved practice adoption in five out of eight units. No safety events were identified since the implementation of pH testing. We are currently continuing to review the data to ensure sustainment and increase compliance with completing pH testing.
Implications for practice:
Utilizing the EBP problem-solving process and implementation strategies, including use of unit-based change champions, are effective for implementation and sustainment of a practice change to improve patient safety.
Document Type
Poster
Publication Date
11-12-2025
Nasogastric/Orogastric Verification: pH or Not to pH?
Background/Introduction:
Review of current literature identified pH testing as superior to air insufflation for verification of Nasogastric/Orogastric placement in pediatric patients 28 days and older. X-ray is considered the gold standard but not practical. The practice of auscultation has risk of incorrect placement, which can have negative patient outcomes if you introduce formula or breast milk into the lungs.
Purpose:
The purpose of this initiative was to implement best practice for Nasogastric/Orogastric placement verification in infants and children 28 days and older to prevent safety events associated with incorrect placement.
Implementation plan:
With this information, a suburban children’s hospital identified the opportunity to improve patient safety through the implementation of pH verification for Nasogastric/Orogastric placement. This evidence-based practice initiative was implemented in October 2022. The pH verification initiative was implemented across two campuses (8 units) of the Children’s Hospital. A workgroup was formed, and unit champions were identified within each pediatric unit. Nurses were educated by reviewing guideline changes and completing a voice-over PowerPoint. Once the education was completed, unit champions completed a hands-on return demonstration with each nurse. The team worked with Clinical Informatics for the pH results to be built into the Electronic Medical Record. The team worked with Supply Chain to order and stock the necessary supplies for pH testing. The workgroup created educational tools for post-implementation. Post-implementation data was collected and PDSA cycles were utilized to increase practice adoption in all units.
Outcomes:
Post-implementation data shows improved practice adoption in five out of eight units. No safety events were identified since the implementation of pH testing. We are currently continuing to review the data to ensure sustainment and increase compliance with completing pH testing.
Implications for practice:
Utilizing the EBP problem-solving process and implementation strategies, including use of unit-based change champions, are effective for implementation and sustainment of a practice change to improve patient safety.
Affiliations
Advocate Children's Hospital - PR & OL