No / There are well-recognised complications associated with malposition of nasogastric (NG) tubes. In 2011 the UK National Patient Safety Agency (NPSA) published an alert regarding their insertion and position confirmation. This alert also identified the expected radiology standards for both image acquisition and reporting. This was a retrospective review of referrals over a six-month period within a multi-site NHS Trust. A consecutive sampling approach was used and radiology reports where the text included the terms “NG tube”, “nasogastric” or “feeding” were included. Data were collected from the radiology information system and NG tube visibility and image quality were confirmed by two independent reviewers. 1137 examinations demonstrated an NG tube, of which 68.3% were performed to check tube position. There was statistically significant correlation between lower radiation exposure and non-visualisation (Fishers exact test, p < 0.001). The number of examinations with higher exposure index (EI) in the NG check cohort suggests that the radiographer increased the exposure to improve visualization (x2 = 2.846; 95% CI; p = 0.046), although the utility of this is unproven. Malplaced tubes were demonstrated either in the respiratory tract (1.8%) or proximal gastrointestinal tract (8.6%) as a result of insufficient length introduced. The prompt acquisition and reporting of radiographs is essential to reduce the risk of NG tube complications. Respiratory tract misplacement rates were in line with the published literature, but this study does raise concern regarding the number of tubes located in the proximal GI tract. Radiology's responsibility in accurate and effective reporting of medical interventions is significant.

Sväljsvårigheter uppstår hos individer med avancerad form av demens som en del av sjukdomsprocessen. Det ställer krav på hälso- och sjukvården att bemöta dessa symtom när individen själv saknar den kognitiva förmågan att fullt hävda sin autonomi avseende nutritionsbehandling. Frågan om sondnäring via sond eller PEG är en adekvat behandling för dessa patienter aktualiseras. Även om det rent utav är ett övergrepp och omvårdnaden istället bör ta en palliativ riktning. Sjuksköterskan betraktar ofta sin kunskap inom området som egna personliga preferenser och inte något som kan hänvisas till i ett kliniskt vårdsammanhang. Syftet med denna studie var att utforska sjuksköterskans etiska medvetenhet kring administrering av sondnäring till individer med avancerad form av demens. Studien genomfördes utifrån en kvalitativ design med en empiriskt utformad intervju, en litteraturöversikt samt en etisk analys utifrån sjuksköterskans möjliga handlingsalternativ i beslutandeprocessen. Slutsatser av denna studie består till en del av att sjuksköterskan bör agera som advokat för individens upplevda bästa och önskemål, ej stödja läkares beslut om administrering av sondnäring till dessa patienter samt bidra till en värdig död inom den palliativa domänen för individen med minsta möjliga lidande som resultat. / Swallowing difficulties occur as a part of the disease process in individuals with advanced dementia. Demands is set on the healthcare-staff to meet with these symptoms when the individual due to loss in cognitive function, lack a complete ability to claim autonomy regarding nutritional treatment. The issue arises regarding enteral feeding by PEG or NG-tube as a viable treatment option for these patients. Even if it is an encroachment and that the care instead should be performed from a palliative point of view. Registered nurses view their knowledge within the area as personal preferences that they cannot refer to in a clinical setting. The aim of this study was to explore the nurse´s ethical awareness regarding enteral nutrition to individuals with advanced dementia. The study was conducted from a qualitative approach with an empirical interview, a literature review and an ethical analysis concerning the nurse’s possible actions’ in the decision making-process. Conclusions of this study consists to a part of that the nurse should act as the patient’s advocate regarding from what’s perceived to be the best for the patient and the patient’s wishes. Also, not supporting the doctor’s decision of tube feeding to these patients’ and to contribute to a dignified death within the palliative domain, with least possible suffering as a result.