Highlights
- •Nasogastric tube placement verification
- •Evaluation methods for nasogastric tube placement
- •Best practice for nasogastric tube placement
- •Hospitalized children with nasogastric tubes
- •Evidence based practice
Abstract
Background
Nasogastric (NG) feeding tubes are used to deliver nutrition, hydration, and medications
to hospitalized infants and children but the ongoing use of non-evidence-based practice
(EBP) methods to confirm NG tube (NGT) placement has been associated with adverse
patient events.
Methods
A study was undertaken to ascertain if practice changes have occurred since findings
from a previous study were published by the New Opportunities for Verification of
Enteral tube Location (NOVEL) project. The NOVEL project was an initiative of the
American Society of Parenteral and Enteral Nutrition (ASPEN). A survey was distributed
to member organizations participating in the NOVEL project. Respondents were also
asked if and when a change in practice occurred in the policy for NGT placement verification,
if there was variation within the institutional units and if there were barriers to
practice change.
Findings
Respondents were primarily nurses (205/245) from 166 institutions that provided care
to combined adult/pediatric/neonatal (122/166) patients. Respondents indicated a radiograph
(64%) or pH measurement (24%) were best practice but in actual practice 42% use pH
measurement and 23% use a radiograph to verify NGT placement. There was variability
within institutions, with the Neonatal Intensive Care Unit (NICU) most often using
aspiration and direct eye visualization to verify placement and the other units within
the institutions using EBP method(s).
Discussion
Comparing these results to previous work by the NOVEL project shows an increase toward
the use of EBP method(s) to verify NGT placement verification.
Application to practice
This study demonstrates variation within units at the same facility using methods
unsupported by the literature, demonstrating that many centers still rely on non-EBP
methods of NG placement confirmation, despite cautions issued by many major healthcare
organizations.
Keywords
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Article info
Publication history
Published online: November 08, 2021
Accepted:
October 22,
2021
Received in revised form:
October 19,
2021
Received:
April 24,
2021
Identification
Copyright
© 2021 Published by Elsevier Inc.
