Meeting nutritional needs of hospitalized patients can be challenging. We know using the gut is superior to parenteral nutrition because it maintains intestinal function, has fewer complications, and is less costly (Cerra, 1997). If a patient is unable to swallow safely, enteral feeding is recommended. Enteral tube positioning has always been an area of discussion for nurses. Research has shown a malpositioned tube that has been used to deliver feedings or medication can result in aspiration, pneumothorax, and sepsis (Simons & Abdallah, 2012). Which method for verifying enteral tube placement is best according to the evidence?
The authors of the article published in the February issue of the American Journal of Nursing,
"Bedside Assessment of Enteral Tube Placement: Aligning Practice with Evidence
," critically appraised the research around the current methods being used to verify feeding tube placement. The authors found that the 5 most common methods used in practice are:
- X-ray visualization of the tube
- pH testing of aspirate
- Visual assessment of aspirate
- Visualization of external tube length
- Auscultation of air insufflated through the feeding tube (Simons & Abdallah, 2012).
The research clearly shows that the most reliable method of verifying enteral tube placement is an X-Ray (Simons & Abdallah, 2012). I encourage each of you to read this article and adopt the evidence of enteral tube placement verification in your institution. This evidence-based intervention will improve your patient outcomes and decrease your costs due to complications associated with improper placement of enteral feeding tubes.
Cerra, F, et al. 1997. Applied nutrition in ICU patients. A consensus statement of the American College of Chest Physicians. 111(3): 769-78.
Simons, S., Abdullah, L. 2012. Bedside assessment o f enteral tube placement: aligning practice with evidence. American Journal of Nursing, 112(2).
Anne Dabrow Woods, MSN, RN, CRNP
Chief Nurse and Publisher
Wolters Kluwer Health Medical Research