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Methods used by critical care nurses to verify feeding tube placement in clinical practice
Annette M Bourgault1, Janie Heath2, Vallire Hooper2
1Annette M. Bourgault is an assistant professor and interim assistant dean for assessment and development at Georgia Regents University, College of Nursing, in Augusta.Janie Heath is dean of the College of Nursing at University of Kentucky in Lexington.Vallire Hooper is the manager of nursing research at Mission Hospital in Asheville, North Carolina.Mary Lou Sole is the Orlando Health Distinguished Professor at University of Central Florida, College of Nursing, in Orlando.Elizabeth G. NeSmith is an associate professor and chair of the Department of Physiological and Technological Nursing at Georgia Regents University, College of Nursing, in Augusta. abourgault@gru.edu.
Background:
The American Association of Critical-Care Nurses practice alert on verification of feeding tube placement makes evidence-based practice recommendations to guide nursing management of adult patients with blindly inserted feeding tubes. Many bedside verification methods do not allow detection of improper positioning of a feeding tube within the gastrointestinal tract, thereby increasing aspiration risk.
Objectives:
To determine how the expected practices from the American Association of Critical-Care Nurses practice alert were implemented by critical care nurses.
Methods:
This study was part of a larger national, online survey that was completed by 370 critical care nurses. Descriptive statistics were used to analyze the data.
Results:
Seventy-eight percent of nurses used a variety of methods to verify initial placement of feeding tubes, although 14% were unaware that tube position should be confirmed every 4 hours. Despite the inaccuracy of auscultation methods, only 12% of nurses avoided this practice all of the time.
Conclusions:
Implementation of expected clinical practices from this guideline varied. Nurses are encouraged to implement expected practices from this evidence-based, peer reviewed practice alert to minimize risk for patient harm.
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