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

Arch Dis Child. 2024 Apr 22:archdischild-2024-327039. doi: 10.1136/archdischild-2024-327039. Online ahead of print.

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.

Keywords: Adolescent Health; Child Psychiatry; Mental health; Paediatrics.