The Implementation of Post-Gastrostomy Tube Nursing Management Using Evidence-based Practice Guidelines: Assessing a Practice Change for Nursing Knowledge Retention, Confidence and Practice Change Feasibility

Abstract

A lack of universally implemented evidence-based practice (EBP) guidelines were found in the inpatient setting at a moderate-sized Southwest Florida hospital for the daily nursing care management of newly placed percutaneous endoscopic gastrostomy (PEG) tubes. The purpose of this Doctoral of Nursing Practice (DNP) change project was to standardize the daily nursing care management of newly placed PEG tubes using EBP guidelines. The design of this EBP change project was a 4-week pre/post-test. The objectives of this DNP project was to (1) administer a pre-implementation questionnaire assessing knowledge retention, confidence in nursing PEG tube care management, and perceived feasibility of incorporating EBP guidelines for daily nursing management of newly placed PEG tubes, (2) implement a 15-20 minute online educational tutorial about EBP guidelines for daily nursing care of newly placed PEG tubes and place an EBP guideline order set for newly placed PEG tubes into the electronic medical record (EMR), 3) administer a post-implementation questionnaire assessing knowledge retention, confidence in nursing PEG tube care management, and feasibility of incorporating the EBP guidelines for daily nursing care management of newly placed PEG tubes change 4-weeks post change project. The findings indicated a change in the confidence level (pre-test M = 5.3, SD =2.3; post-test M = 8.8., SD=1.2; p < 0.01) of the nurses regarding the daily management of a newly placed PEG tube after the implementation of the educational video tutorial and the electronic evidence-based guidelines order set. Incorporating EBP guidelines into the EMR via an order set for the daily nursing management of newly placed PEG tubes appears to be a feasible method for promoting the confidence of nurses providing care for patients with newly placed PEG tubes.