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Nursing management of enteral tube feedings
1College of Nursing, University of Utah, Salt Lake City, USA.
Objective:
To describe the management practices of nurses when providing care to patients receiving enteral tube feedings.
Design:
A descriptive study was conducted with use of questionnaires distributed to registered nurses (RNs).
Setting:
A midwestern university medical center.
Sample:
A total of 235 questionnaires were distributed to RNs. Two hundred nineteen were considered eligible and 180 were usable. This represents an 82% response.
Method:
A 43-item questionnaire with a return envelope was placed in the mailbox of RNs.
Data Analysis:
Descriptive statistics were used to analyze data.
Results:
(1) Checking the flow rate of enteral feeding: Flow rates were checked between 1 to 4 hours by 70% of the nurses, whereas 16% checked every 8 hours, and the remaining 14% checked every 12 hours or longer. (2) Flushing the enteral tube: Ninety-four percent of respondents indicated they regularly flushed the enteral tube before each feeding (29%), after each feeding (43%), and every 4 hours (59%). The types of irrigants that were used for flushing included tap water, sterile water, and sterile normal saline solution. (3) Method of unclogging obstructed tubes: An irrigant solution is the primary intervention reported by nurses to unclog tubes (94%). The types of solutions reportedly used most frequently were carbonated beverage (81%), sterile water (49%), dissolved papain (46%), and tap water (42%). (4) Checking residuals: Most RNs (95%) reported that they check residuals every 4 hours; of these, 50% stated they discard residuals, and 49% stated that they readminister residuals. In regard to the volume of residual deemed to be excessive, 50% of the respondents stated that an amount greater than or equal to 100 ml is excessive. (5) Administering medications: Flushing the enteral tube with water is reported to be done before (47%) and after (95%) giving medicines. When multiple medicines are given, 38% report flushing the enteral tube between each medication.
Conclusion:
The findings of this self-report study suggest that practices regarding management of enteral feedings vary widely among nurses.