INTRODUCTION:

Nasogastric intubation is defined as the passage of nasogastric tube (flexible tube made up of rubber or plastic) through one of the nostrils to the stomach. Nasogastric tube feeding is also known as enteral nutrition and it refers to the administration of nutritionally balanced liquefied food or formula diet.¹

Nasogastric tube feeding is a common method of maintaining adequate nutritional status and hydration of patients who are unable to take sufficient nutrition orally like in dysphasia, jaw fracture, surgery of mouth and oesophagus, pharyngitis, oesophagitis, bulbar palsy, burns, pancreatitis, post operative patients, cerebral vascular accidents, progressive oral and pharyngeal tumours, degenerative neurological disorders.

Nurses must have adequate knowledge and skills of tube feeding. ²

Many studies have reported that, despite the importance of enteral nutrition and existing data on evidence based nutritional guidelines; nutrition is still a significant concern in hospitals. ³

It is therefore important to take this concept seriously, to ensure that nurses' nutritional practices for the critically ill adults are evidence based. This demonstrates that nurses have an impact on the outcome of enteral nutritional support.⁴

OBJECTIVES:

· To assess the knowledge regarding nasogastric tube feeding among staff nurses working in selected hospitals of district Mohali.

· To assess the skills regarding nasogastric tube feeding among staff nurses working in selected hospitals of district Mohali.

· To find out co- relation between knowledge and skills regarding nasogastric tube feeding among staff nurses working in selected hospitals of district Mohali.

· To find out association between knowledge score of staff nurses and selected socio-demographic variables.

· To find out association between skills of staff nurses and selected socio-demographic variables.

MATERIAL AND METHOD:

A quantitative research approach was adopted for the study with descriptive research design to achieve the objectives of the study .Non probability convenient sampling technique was used to draw sample of 100 staff nurses working in a 205 bedded private hospital of district Mohali who fulfilled inclusion criteria. Knowledge and practices of staff nurses regarding nasogastric tube feeding were assessed by knowledge questionnaire and observational checklist respectively.

Inclusion Criteria:

Staff nurses who were:

a) Available during data collection period.

b) Willing to participate in the study.

c) Gave written informed consent for participating in research study.

Exclusion Criteria:

Staff nurses were-

a) On leave at the time of data collection.

RESULTS:

Table 1: Frequency and percentage distribution of staff nurses according to socio-demographic variables. N=100

S. No.	Socio –demographic variables	Frequency (f)	Percentage (%)
1.	Age (in years)
	23-27	55	55
	28-32	32	32
	33-37	08	8
	38-42	05	5
2.	Gender
	Male	04	4
	Female	96	96
3.	Educational qualification
	General Nursing Midwifery	65	65
	Basic B.Sc. Nursing	23	23
	Post basic B.Sc. Nursing	12	12
	M.Sc. Nursing	0	0
4.	Total work experience ( in years)
	≤2	57	57
	2-4	30	30
	4-6	09	9
	>6	04	4
5	Present area of work
	ICU	27	27
	CCU	07	7
	HDU	11	11
	General ward	55	55
6	Duration of work in present area ( in years )
	≤2	68	68
	2-4	26	26
	4-6	06	6
	>6	0	0
7	In service education attended related to nasogastric tube feeding
	Yes	29	29
	No	71	71

Table 1 shows that majority of subjects i.e.55% were in the age group of 23-27 years and 96% were females .65% staff nurses where having educational qualification as General Nursing and Midwifery.

In this study, majority of staff nurses i.e. 57% were having ≤2 years of total work experience, 55 % were working in general ward and 68 % were having ≤2 years of work experience in present area. Out of 100 staff nurse, 71 of them have not attended in -service education program related to nasogastric tube feeding

Table: 2 Frequency and percentage distribution of staff nurses according to level of knowledge regarding nasogastric tube feeding. N=100

Level of knowledge	Knowledge score	Frequency (f)	Percentage ( %)
Poor	0-10	0	0
Average	11-20	54	54
Good	21-30	46	46
Median (Min.-Max.)	20 (14-25)
Mean ±SD	20.0±2.5

Table 2 depicts that majority of the staff nurses i.e. 54 % fall into a category of average knowledge and 46% had good knowledge. None of them falls into category of poor knowledge.

Table 3: Frequency and percentage distribution of staff nurses according to level of skills regarding nasogastric tube feeding N=100

Level of skills regarding nasogastric tube feeding	Skills score	Frequency (f)	Percentage (%)
Poor	1-12	0	0.0
Fair	13-28	42	42.0
Good	29-42	58	58.0
Median (Min. –Max.)	29.0 (25-34)
Mean ±SD	29.11±2.234

Table 3:

depicts that majority of the staff nurses i.e. 58% have good skills and 42% fall into category of fair skills good skills. None of them falls into category of poor skills.

Table 4: Correlation between knowledge and skills regarding nasogastric tube feeding. N=100

Research variables

Mean

Standard deviation

Karl Pearson correlation

Inference

Knowledge

20.07

2.5

r = 0.127

Weak positive correlation

Skills

29.11

2.234

p -value < 0.001

Table 4 depicts that there is weak positive correlation between knowledge and skills regarding nasogastric tube feeding when calculated by using Karl Pearson correlation formula, (r = 0.1)

Table 5: Association of level of knowledge regarding nasogastric tube feeding with selected socio-demographic variables. N= 100

Socio demographic variables	Level of knowledge				$χ$ $2$ ,df, p-value
	Average (n₁=54)		Good (n₂=46)		$χ$ $2$ ,df, p-value
	f₁	%	f₂	%
Age (in years)
23-27	27	49.1	28	50.9	4.608 3 0.203^NS
28-32	18	56.3	14	43.7
33-37	7	87.5	1	12.5
38-42	2	40.0	3	60.0
Gender
Male	3	75.0	1	25.0	0.740 1 0.39^NS
Female	51	53.1	45	46.9	0.740 1 0.39^NS
Educational qualification
GNM	38	58.5	27	41.5	1.623 2 0.444^NS
Basic B.Sc. Nursing	10	43.5	13	56.5
Post basic B.Sc. Nursing	6	50.0	6	50.0
M.Sc. nursing	0	0	0	0
Total work experience ( in years )
≤2	29	50.9	28	49.1	2.303 3 0.512^NS
2-4	16	53.3	14	46.7
4-6	7	77.8	2	22.2
>6	2	50.0	2	50.0
Present area of work
ICU	18	66.7	9	33.3	3.925 3 0.27^NS
CCU	5	71.4	2	28.6
HDU	5	45.5	6	54.5
General ward	26	47.3	29	52.7
Duration of work in present area (in years )
≤2	34	50.0	34	50.0	1.420 2 0.492^NS
2-4	16	61.5	10	38.5
4-6	4	66.5	2	33.5
>6	0	0	0	0
In -service education program attended related to nasogastric tube feeding
Yes	17	58.6	12	41.4	.351 1 0.554^NS
No	37	52.1	34	47.9	.351 1 0.554^NS

NS - Non significant at p< 0.05

Table 5 depicts that there is no significant association of knowledge with age, gender educational qualification, total work experience, present area of work, duration of work in present area, and in-service education program attended related to nasogastric tube feeding at p<0.05

Table 6 depicts that there is no significant association of skills with age, gender, educational qualification, total work experience, present area of work, duration of work in present area, in -service education program attended related to nasogastric tube feeding at p<0.05.

Table 6: Association of level of skills regarding nasogastric tube feeding with selected socio demographic variablesN=100

Socio demographic Variables	Level of skills										$χ$ $2$ , df, p-value
	Fair (n₁=42)			Good (n₂=58)
	f₁	%		f₂			%
Age( in years)
23-27	16			29.1		39			70.9		6.501 3 0.087^NS
28-32	20			62.5		12			37.5
33-37	4			50		4			50
38-42	2			40		3			60
Gender
Male	1			25		3			75.0		0.494 1 0.482^NS
Female	41			42.7		55			57.3
Educational qualification
GNM			26		40			39		60.0	0.443 2 0.801^NS
Basic B.Sc. Nursing			10		43.5			13		56.5
Post basic B.Sc. Nursing			6		50			6		50
M.Sc. nursing			0		0			0		0
Total work experience (in years)
≤2			18		31.6			39		68.4	6.658 3 0.084^NS
2-4			18		60.0			12		40
4-6			4		44.4			5		55.6
>6			2		50.0			2		50
Present area of work
ICU			9		33.3			18		66.7	1.606 3 0.658^NS
CCU			3		42.9			4		57.1
HDU			4		36.4			7		63.6
General ward			26		47.3			29		52.7
Duration of work in present area (in years )
≤2			25		36.8			43		63.2	2.421 2 0.298^NS
2-4			14		53.8			12		46.2
4-6			3		50			3		50
>6			0		0.0			0		0
In- service education program attended related to nasogastric tube feeding
Yes			14		48.28			15		51.72	.303 1 0.082^NS
No			28		39.44			43		60.56

NS - Non significant at p<0.05

CONCLUSION:

· The present study concluded that majority of staff nurses i.e. 54 % fall into a category of average knowledge and 46% had good knowledge. None of them falls into category of poor knowledge.

· A finding also reveals that there is a weak positive correlation between knowledge and skills regarding nasogastric tube feeding.

DISCUSSION:

· A similar study conducted by Huffmans, Pieper P, Jarczyk K, Bavne S that majority of the nurse respondents (66%) had moderate knowledge regarding nasogastric tube feeding. ⁵

· A similar study was conducted by AhamedN, Mondal D 2014 showed that there was moderately positive correlation between knowledge and practice of staff nurses regarding Ryle’s tube feeding(r=0.46). ⁶

ACKNOWLEDGEMENT:

I would like to express my sincere gratitude to the participants of study who had spent their valuable time for giving the information.

CONFLICT OF INTEREST:

There is no conflict interest in this study.

SOURCE OF FUNDING:

Self

ETHICAL CLEARANCE:

· A formal written permission was obtained from private hospital and ethical committee

· Written informed consent was taken from the staff nurses.

· Anonymity of staff nurses was maintained.

REFERENCES:

1. Perry P, Griffin A. Basic nursing essentials for practice. 6^thed. New Delhi: Mosby publication;2007

2. Shlamovitz G, Kate V. Indication of nasogastric tube clinical trial feeding. July 2016 Available from :http://medicine.medscape.com/article/80925.

3. Mowe M, Bosaeus I, Rasmussen H. Nutritional routines and attitudes among doctors and nurses in Scandinavia. A questionnaire based survey. Clinical Nutrition;2006Availablefrom:https://www.ncbi.nlm.nih.gov/pubmed/16701921

4. Mathus-Vliegen EM, Bredius MW . Analysis of sites of bacterial contamination in an enteral feeding system. JPEN Journal of Parentra &Enteral Nutrition. 2006 ;30:519 Avaiblefrom:https://www.ncbi.nlm.nih.gov/pubmed/17047178

5. Huffmans, Pieper P, Jarczyk K, Bavne S. Enteral nutrition among geriatric patient 2006 Jan –Feb Available from: [homepage on the Internet ] http://wwwncbi.nlm.gov/ pubmed.

6. Ahamed N, Mondal D. knowledge and practice of staff nurses regarding ryles tube feeding in a selected hospital of Kolkata .SMU Medical Journal Hospital. 2014; 1(2):56-59. Available from: http://medjournal.smu.edu.in/articles/2014july/28.pdf

Received on 06.10.2017 Modified on 30.10.2017

Asian J. Nursing Education and Research. 2018; 8(3): 385-388.

DOI: 10.5958/2349-2996.2018.00079.4