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Patients with head and neck cancers are often intubated with nasogastric tube after surgery for nutrition provision and infection prevention. The rate of deliberate self-extubation of nasogastric tube was 3.60% among patients after surgery in our hospital from January to February, 2012. By investigating cases of successful extubation, our team was able to identify the major factors behind the premature self-extubation: low rate of patient education delivered by nurses according to patients' needs (only 13.33%), and low percentage of consistency in patients' descriptions of their experience after nasogastric intubation (23.96%). This project was aimed to reduce the self-extubation rate of nasogastric tube among patients with head and neck cancers to 0.72%. The nursing interventions included: 1. develop and implement nasogastric tube care model: (i) set the care model as a key point in the patient education shift routine, (ii) set the care model as a focal point for each shift, and (iii) establish effective communication and feedback; 2. encourage case discussions using positive feedback and revise care model accordingly; 3. revise patient education pamphlets. After the project was implemented, from Sept. 2012 to August 2013, the rate of deliberate self-extubation of nasogastric tube was reduced to 0.57%. This result indicates that our nasogastric tube care model is effective in reducing the rate of deliberate self-extubation of nasogastric tube among patients with head and neck cancers after surgery. [ABSTRACT FROM AUTHOR]

Catheter-related bladder discomforts (CRBD) can cause patients to forcibly removed their urethral catheters. From March to August 2013, 3 patients unexpectedly removed their urethral catheters and resulted in urethral laceration. The author was motivated to plan and initiate this project to address the issue. From September 9th, 2013 to October 1st, 2013, an audit was carried out using CRBD nursing intervention checklist, and as result the completion rate of CRBD nursing intervention was merely 55.6%. The primary causes were the inability to identify CRBD from the patients' complaints, inadequate nursing knowledge, absence of CRBD nursing measure instructions, and that the patients' main complaints were not pain-related and they were unaware of CRBD. Several solutions were introduced, such as producing posters and video clips promoting health education; introducing new CRBD pain assessment form; and developing empirical-based CRBD nursing guidance. The intended goal of project was to increase the completion rate of CRBD nursing interventions from 55.6% to 80%. The actual result was 82.2%, surpassed our intended goal. The project had relieved CRBD, eliminated premature urethral catheter removals, and enhanced nursing quality. [ABSTRACT FROM AUTHOR]