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Nasogastric tube feeding under physical restraint of children and young people with mental disorders: a comprehensive audit and case series across paediatric wards in England
  1. Sarah Fuller1,2,
  2. Emerie Sheridan2,
  3. Lee D Hudson3,
  4. Dasha Nicholls2
  1. 1Child and Adolescent Mental Health, Northamptonshire Healthcare NHS Foundation Trust, Northampton, Northamptonshire, UK
  2. 2Department of Brain Sciences, Imperial College London, London, UK
  3. 3Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, UK
  1. Correspondence to Sarah Fuller, Child and Adolescent Mental Health, Northamptonshire Healthcare NHS Foundation Trust, Northampton, Northamptonshire, UK; sarah.fuller{at}nhs.net

Abstract

Objective To estimate the number of patients on paediatric wards in England who received nasogastric tube (NGT) feeding under physical restraint from April 2022 to March 2023, identify the demographics and clinical characteristics of these patients, and which personnel facilitated the restraint.

Design Audit and anonymous case series

Setting Paediatric wards in England.

Patients Children and young people receiving this intervention in a 1-year period.

Outcome measures An online survey was sent to all paediatric wards in England, with the option of submitting anonymous case studies.

Results 136/143 (95.1%) acute paediatric units responded. 144 young people received this intervention across 55 (38.5%) paediatric units. The predominant diagnosis was anorexia nervosa (64.5%), age range 9–18 years (M=14.2, SD=2.1). The duration of NGT feeding under restraint ranged from 1 to 425 days, (M=60.2, SD=80.4). Numerous personnel facilitated the restraints, including mental health nurses, paediatric nurses, security staff, healthcare assistants and parents/carers.

Conclusion NGT feeding under restraint is a relatively common intervention in acute paediatric units in England. Understanding the demographics of those receiving this intervention may highlight where additional support is needed. Further research is needed to understand when this intervention transitions from a lifesaving intervention to ongoing management.

  • Child Psychiatry
  • Mental health
  • Paediatrics
  • Adolescent Health

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Footnotes

  • X @ChattyDietitian, @DashaNicholls

  • Contributors SF is the clinical lead dietitian for CAMHS in Northamptonshire Healthcare NHS Foundation Trust and a Research Dietitian at Imperial College London. ES is a research assistant at Imperial College London. SF and ES conducted the survey, data analysis and drafted the manuscript. LH is part of the project steering group and reviewed the final manuscript. DN conceived the research, contributed to the analysis and reviewed the final manuscript. DN is the guarantor for the research and publication.

  • Funding This research was funded by the Humber and North Yorkshire Specialist Mental Health Learning Disability and Autism Provider Collaborative. The views expressed are those of the authors and not necessarily of the Humber and North Yorkshire Specialist Mental Health Learning Disability and Autism Provider Collaborative.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.