A Nurse-Driven Protocol for Neonatal Enteral Access Device Placement Confirmation.

Area of Science:

• Neonatal care
• Quality improvement in healthcare
• Medical device safety

Background:

• Preterm infants often require nasogastric/orogastric enteral access devices (EADs) for nutrition and medication delivery.
• Accurate EAD tip confirmation is critical to prevent complications.
• Current practices relied on limited methods like centimeter markings and unverified visual/auditory checks.

Purpose of the Study:

• To implement an evidence-based protocol for confirming EAD placement.
• To achieve 90% adherence to the new protocol within 90 days of implementation.

Main Methods:

• A nurse-driven, evidence-based protocol was implemented, based on best practice recommendations.
• Education focused on insertion measurement and gastric pH measurement.
• Confirmation methods included radiographs, insertion measurement, centimeter marking, and gastric pH.
• Audits and questionnaires assessed pre- and post-implementation practices.

Main Results:

• Nursing knowledge of EAD insertion and verification improved.
• Gastric pH measurement was incorporated into routine practice.
• Use of auscultation for confirmation significantly decreased.
• Nursing adherence to the protocol reached 92%.

Conclusions:

• The study presents a successful model for implementing a nurse-driven EAD placement confirmation protocol.
• High adherence rates demonstrate the protocol's feasibility.
• Further research is needed to confirm effectiveness and establish neonatal-specific consensus.