[AVBC 2025] Reducing Number of Ward Assessments for Nasogastric (NG) Feeding and Oral Suctioning Caregiver
Care Process & Redesign
Workforce Transformation
Appropriate & Value-based Care Conference
National Healthcare Group
6 November 2025
To improve the percentage of caregivers who become competent within 2 ward assessments from 50% to 80% in 6 months. With high demands for CGTs, these interventions can lead to significant time saving, allowing nurses and physiotherapists to focus on.
Year Submitted: 2025
Published Date: 06 November 2025
Tags: Care Process ＆ Redesign, Workforce Transformation, Caregiver, Informal Workforce Transformation, Workflow Redesign, Quality Improvement
About this Content
Aims
To improve the percentage of caregivers who become competent within 2 ward assessments from 50% to 80% in 6 months.
Background
Singapore's healthcare system is increasingly emphasising community-centred care, with caregivers playing a vital role in providing complex procedures such as nasogastric (NG) feeding and oral suctioning. Tan Tock Seng Hospital (TTSH) developed a hybrid Group Caregiver Training (CGT) model to better equip caregivers through structured, skills-lab practice and ward-based assessments.
Methods
PDSA 1: Translated NG feeding & suctioning educational materials into Bahasa Indonesia and Burmese. Distributed to caregivers in their best understood languages. PDSA 2: Created a template with clear passing criteria for documentation. Used as a handover tool from Group CGT trainers to ward staff. PDSA 2A: Highlighted 'Passing criteria' in red to emphasize the need to follow the criteria during assessment.
Results
For NG feeding, the percentage increased from a median of 67% to 81% after PDSA 1. PDSA2 & 2A led to 100% in September. A dip in October was addressed through reinforcement in Nurses forum, leading to improvements in November. Only 37% completed both NG feeding and oral suctioning within 2 ward assessments. For oral suctioning, the median decreased from 71% to 67% due to knowledge retention from delayed ward assessments and some caregivers needing more support. Results improved in January after reinforcing passing criteria.
Conclusion
With high demands for CGTs, these interventions can lead to significant time saving, allowing nurses and physiotherapists to focus on other essential aspects of patient care and mobilization.
Lessons Learnt
Successful healthcare improvement demands persistent optimism and strategic patience through extended implementation periods. Engaging both healthcare professionals and caregivers in continuous feedback loops proved invaluable for program enhancement and adoption. Sustainable improvement requires systematic monitoring and adaptive refinement based on stakeholder input, ensuring long-term success in our shift towards community-based care.
Additional Information
The team tracked caregivers who attended Group CGT and underwent assessments from June 2024 to January 2025.
Keywords
Nasogastric Feeding, Caregiver Training, Oral Suctioning
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing, Allied Health |
Applicable Specialty or Discipline | Physiotherapy |
Project Lead(s) | Lim Shi Ling |
Project Member(s) | Lee Bin |
Connect with this contributor!
Lim Shi Ling - shi.ling.lim@nhghealth.com.sg