Frequency of nasoenteral tube displacement and associated risk factors

Metheny, Norma A.; Spies, Martha; Eisenberg, Patricia

doi:10.1002/nur.4770090309

Cited by 41 publications

(19 citation statements)

References 4 publications

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“…Even if a nasogastric tube is positioned correctly upon insertion and secured, the distal tip can migrate forward or backward from its original position. [102][103][104] Because nasogastric tubes can be misplaced on insertion or subsequent to initial placement, 2 related traditions in practice will be discussed. The first is associated with morphological measurement used to predict insertion length.…”

Section: Interventionsmentioning

confidence: 99%

Examining the Evidence to Guide Practice: Challenging Practice Habits

Makic

Rauen

Watson

et al. 2014

Critical Care Nurse

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I n 2001, the Institute of Medicine challenged all health care professionals to decrease variation in practice through adoption of practice interventions based on best evidence to improve patients' outcomes.1 Current reviews of clinical practice suggest that only 10% to 15% of clinicians consistently implement evidence-based care 2 and indicate that it may take up to 2 decades for original research to be put into routine clinical practice.3 It is well established that evidence-based practice (EBP) is associated with higher quality care and better outcomes for patients than care that is steeped in tradition. 4 Yet at times, clinicians continue to practice on the basis of tradition.

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Section: Interventionsmentioning

confidence: 99%

Examining the Evidence to Guide Practice: Challenging Practice Habits

Makic

Rauen

Watson

et al. 2014

Critical Care Nurse

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“…66,67 For this reason, it is necessary to monitor tube location at regular intervals while the tube is being used for feedings or medication administration. Observing for change in external tube length:…”

Section: Aacn Practice Alertmentioning

confidence: 99%

“…Observing for a change in length of the external portion of the feeding tube (as determined by movement of the marked portion of the tube) may be helpful in detecting tube dislocation. 65,66 Reviewing routine chest and abdominal radiography reports:…”

Section: Aacn Practice Alertmentioning

confidence: 99%

Initial and Ongoing Verification of Feeding Tube Placement in Adults (applies to blind insertions and placements with an electromagnetic device)

2016

Critical Care Nurse

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Level A Meta-analysis of quantitative studies or metasynthesis of qualita tive studies with results that consis tently support a specifi c action, intervention, or treatment (including systematic review of randomized controlled trials) Level B Well-designed, controlled studies with results that consistently support a specifi c action, intervention, or treatment Level C Qualitative studies, descriptive or correlational studies, integrative reviews, systematic reviews, or randomized controlled trials with inconsistent results Level D Peer-reviewed professional and organizational standards with the support of clinical study recommendations Level E Multiple case reports, theory-based evidence from expert opinions, or peer-reviewed professional organizational standards without clinical studies to support recommendations Level M Manufacturer's recommendations only by AACN on April 4, 2019

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“…33 Observe for a change in length of the external portion of the nasogastric tube (if not adequately secured, the nasogastric tube may become dislocated upon patient repositioning during care).…”

mentioning

confidence: 99%

Administering Polyethylene Glycol Electrolyte Solution Via a Nasogastric Tube: Pulmonary Complications

Metheny

Meert

2017

American Journal of Critical Care

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Background Patients sometimes require insertion of a nasogastric tube for the administration of a large volume of a polyethylene glycol electrolyte solution. If the tube is malpositioned, the risk for direct instillation of the solution into the lung increases. The risk for aspiration also increases if the infusion rate exceeds gastrointestinal tolerance. Purpose To review published cases of patients’ experiencing adverse pulmonary events after administration of polyethylene glycol electrolyte solution via a nasogastric tube and to offer suggestions to prevent these outcomes. Methods A search of the literature from 1993 through 2014 was performed by using the PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Scopus databases. Results In the 12 case reports located, none of the patients had radiographs to verify tube location before infusion of polyethylene glycol electrolyte solution. After symptoms developed in 3 children (ages 8–11 years), radiographs showed their tubes incorrectly positioned in the bronchus, lung, or esophagus; ports of a fourth child’s tube were in the oropharynx. The remaining 8 patients (ages 5–86 years) never had radiographs to determine tube placement. Pulmonary complications from the infusions of polyethylene glycol electrolyte solution contributed to the death of 5 of the patients. Conclusion Relatively simple maneuvers to reduce the likelihood of adverse pulmonary events following the administration of large volumes of polyethylene glycol electrolyte solution via a nasogastric tube are well worth the cost and effort to protect patients from potential serious injury.

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Frequency of nasoenteral tube displacement and associated risk factors

Cited by 41 publications

References 4 publications

Examining the Evidence to Guide Practice: Challenging Practice Habits

Examining the Evidence to Guide Practice: Challenging Practice Habits

Initial and Ongoing Verification of Feeding Tube Placement in Adults (applies to blind insertions and placements with an electromagnetic device)

Administering Polyethylene Glycol Electrolyte Solution Via a Nasogastric Tube: Pulmonary Complications

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