New NG feeding sofa is better for staff and patients

The naso-gastric (NG) feeding sofa is a joint collaboration in design between Andy Johnston Associates, the Ellern Mede Services (CAMHS Tier 4 Eating Disorders), and Pineapple Contracts.

The objective was to dramatically improve safety and clinical effectiveness of NG feeding, while reducing the emotional and mental impact on the user.

It also improves operational efficiencies, such as reduced staff and service user injury, loss of man hours, and increased staff welfare.

Ellern Mede is a 10- bed unit that admits young people with eating disorders and various comorbidities, including challenging behaviour, self-harm and violence and aggression due to a refusal of treatment and a fear of eating.

Due to young person’s diagnosis, nutrition and medication are often administered via a Naso-gastric tube with the use of physical restraint. During a day there can be between 2-18 NG feeding treatments under restraint per day. The duration per feed is approximately 15 minutes and a minimum of four staff members are used for each feed.

Infection control from purging behaviour and spillages of aspirates is a consideration and injuries to staff and patients due to unsuitable NG feed sofas can occur.

In order to retain the human and user experience at the centre of the design for the new product, the value creation and delivery process was validated by users and staff throughout the design phase.

Using means-end theory, every aspect of the sofa was taken as an individual opportunity to solve a problem:

• An ergonomic patient seat with seat back recessed compared to outside seating gives a comfortable position to relax patients. The patient’s head can be positioned closer to the staff standing behind the sofa in order to administer feeding and head restraint protocols.
• An angled back and seat for staff means a more-comfortable seating position for staff, with increased back support. Staff face towards the user without having to twist, reducing potential injuries and strains and improving strength of hold. It also prevents staff being propelled off the seat if forcibly impacted from the user’s direction.
• A recessed bottom edge creates an ergonomic leg support for staff while also leaving room for patient and staff feet to be placed comfortably and with stability. It retains space for staff to approach with a feeding tube without being obstructed and allows extra leg room for dealing with resisting patients and space for implementing leg-on-leg techniques.

• The patient seat has been lowered, improving access to the user and creating improved ergonomic posture and comfort for staff performing leg restraints.
• An elevated patient seat edge increases the height of the front lip of the patient seat, keeping the hips slightly lower than the knees, and introducing increased safety for both users and staff by reducing the speed with which a user can escalate from the seat and preventing possible slipping away from the seat.

Benefits include a safer process, lower costs, less time consumed in NG feed under restraints, a reduction in the risk of back injuries, less sick leave, improved infection control, and fewer staff members needed per feed.