A review on the effectiveness of multimodal infection control programmes in the reduction of bacterial contamination in residential care home for elderly persons with nasogastric tube feeding

Ms Suk Ki Ho1,

Professor Diana T. F. Lee2

1School of Nursing, The Hong Kong Polytechnic University , Hung Hom, Hong Kong,

2The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong


 It has been reported that Methicillin Resistant Staphylococcus Aureus (MRSA) colonized in the nasal cavity of residents with a nasogastric tube (NG tube) in residential care home for elders (RCHEs). Inadequate infection control knowledge regarding NG tube feeding among RCHEs staff has been found to lead to bacterial contamination of NG tube feeding system.


 A comprehensive search for original research published between 1990 to 2017 was conducted through the electronic databases CINHAL, CNKI, Cochrane Library, Medline (2000+) and Ovid nursing. The search included all English and Chinese articles with search term descriptors of “NG tube feeding” and “infection control education”.


 Four articles met the review objectives. Two were cluster RCTs, another were RCTs and quasi-experimental pretest posttest control study. The common characteristic of these four studies was to implement multimodal teaching strategies in Infection Control Programmes (ICPs) to RCHEs staff. Multimodal strategies are a combination of interactive group education, skill observation and feedback of performance to enhance infection control knowledge of RCHEs staff. Among them, two studies showed no change in the overall MRSA infection rate while two studies found significant reduced MRSA colonization in NG tubes after multimodal ICPs. Indeed, only one study demonstrated multimodal ICP could enhance the knowledge and skill of NG tube feeding among RCHEs staff.


 Evidence was not strong to demonstrate the effectiveness of multimodal ICPs in the reduction of the NG tube feeding contamiantion. Further studies are recommended to establish a well-designed multimodal ICP to reduce NG tube feeding contamination.


Ms. Sukki Ho is a Clinical Associate of the Hong Kong Polytechnic University. She has been a registered nurse since 1998. She obtained an Outstanding Academic Award in a programme of ‘Master of Infection Control in Health Care Professional” in 2010. She has been a clinical lecturer of School of Nurisng since 2010. Her reseach interests are infection control and pain management in nursing homes with publicaitons. She is now studying a doctoral programme in the Nethersole School of Nursing, the Chinese University of Hong Kong.

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