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Use of Temporary Enteral Access Devices in Hospitalized Neonatal and Pediatric Patients in the United States
Beth Lyman1, Carol Kemper2, LaDonna Northington3
1Children's Mercy Hospital, Kansas City, Missouri blyman@cmh.edu.
Insights
Temporary enteral access devices (EADs) are common in pediatric and neonatal care, with a 24% prevalence. Neonatal intensive care units (NICUs) show the highest usage, and verification methods for tube placement vary widely among hospitals.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Care
- Medical Device Utilization
Background:
- Temporary enteral access devices (EADs) like nasogastric (NG), orogastric (OG), and postpyloric (PP) tubes are crucial for nutrition, fluid, and medication delivery in pediatric and neonatal patients.
- Despite widespread use, data on the prevalence, location, sizing, and placement verification of these temporary EADs in pediatric settings are limited.
Purpose of the Study:
- To determine the prevalence of temporary enteral access device usage in pediatric and neonatal inpatient populations.
- To identify the inpatient locations with the highest prevalence of EAD use.
- To investigate the methods used for verifying the placement of these devices.
Main Methods:
- A multicenter, 1-day prevalence study was conducted across 63 participating hospitals.
- Data collected included the number of NG, OG, and PP tubes, patient demographics (age, weight), location within the hospital, and methods for verifying initial tube placement.
Main Results:
- An overall prevalence of 24% (1991 EADs out of 8333 patients) was observed.
- Nasogastric tubes were most common (66%), followed by orogastric (21%) and postpyloric (17%).
- The neonatal intensive care unit (NICU) had the highest prevalence (61%), with significant variation in placement verification methods reported.
Conclusions:
- Temporary enteral access devices are frequently utilized in pediatric and neonatal care.
- There is considerable variability in the methods employed by hospitals to verify the correct placement of these essential devices.
Background:
Temporary enteral access devices (EADs), such as nasogastric (NG), orogastric (OG), and postpyloric (PP), are used in pediatric and neonatal patients to administer nutrition, fluids, and medications. While the use of these temporary EADs is common in pediatric care, it is not known how often these devices are used, what inpatient locations have the highest usage, what size tube is used for a given weight or age of patient, and how placement is verified per hospital policy.
Materials And Methods:
This was a multicenter 1-day prevalence study. Participating hospitals counted the number of NG, OG, and PP tubes present in their pediatric and neonatal inpatient population. Additional data collected included age, weight and location of the patient, type of hospital, census for that day, and the method(s) used to verify initial tube placement.
Results:
Of the 63 participating hospitals, there was an overall prevalence of 1991 temporary EADs in a total pediatric and neonatal inpatient census of 8333 children (24% prevalence). There were 1316 NG (66%), 414 were OG (21%), and 261 PP (17%) EADs. The neonatal intensive care unit (NICU) had the highest prevalence (61%), followed by a medical/surgical unit (21%) and pediatric intensive care unit (18%). Verification of EAD placement was reported to be aspiration from the tube (n = 21), auscultation (n = 18), measurement (n = 8), pH (n = 10), and X-ray (n = 6).
Conclusion:
The use of temporary EADs is common in pediatric care. There is wide variation in how placement of these tubes is verified.
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