Nasal Bridle Policy

Introduction

One of the most common complications of enteral tube feeding is tube dislodgement. Studies suggest that between 40-80% of Enteral Feeding Tubes (EFTs) – both Naso- Gastric Tubes (NGTs) and naso- jejunal tubes (NJTs) become dislodged due to a variety of patient and staff-related factors.

Placement of both NGTs and NJTs is a time, resource, and labour intensive process, especially when undertaken repeatedly following frequent tube displacement. This results in feeding delays and decreased calorific intake, which can affect a patient’s outcome. In addition, repeated tube replacement increases the risk of potential complications related to tube insertion and results in increased referral rates for Percutaneous Endoscopic Gastrostomies (PEG) and parenteral nutrition. Both carry inherent risks and complications and may not be appropriate.

Nasal bridles (also known as nasal loops) are devices which fix EFTs in place to prevent accidental removal. The bridle loops around the nasal septum and vomer bone and is fixed to the EFT. It can be placed at the patient’s bedside, usually but not exclusively, at the time of insertion of the EFT. The nasal bridle can stay in for the lifespan of the EFT and can be removed when required.

Nasal bridles are designed to reduce the rate of EFT dislodgement and thus avert risks and costs associated with repeated tube placement and help ensure ongoing nutrition is provided.

The decision to use a nasal bridle should, where possible, involve the patient and family/carers. Where the patient does not have capacity to make an informed decision, a decision must be made in their best interest under the Mental Capacity Act 2005. This policy has been written to enable practitioners to follow an agreed decision making, assessment and procedure process.

Policy Details

See also:

• Mental Capacity Policy
• Adult Safeguarding Policy
• Deprivation of Liberty Policy
• Adult Enteral Feeding Policy
• Mittens Policy