TY - JOUR
T1 - Nasoenteral feeding tube placement by nurses using an electromagnetic guidance system (with video)
AU - Mathus-Vliegen, Elisabeth M. H.
AU - Duflou, Ann
AU - Spanier, Marcel B. W.
AU - Fockens, Paul
PY - 2010
Y1 - 2010
N2 - BACKGROUND: The early institution of feeding in patients who need postpyloric feeding tubes is often hampered by a limited availability of endoscopists experienced in safe tube positioning. OBJECTIVE: To test the feasibility of having nurses place postpyloric feeding tubes by using a universal path finding system device. DESIGN: Prospective study. SETTING: Academic hospital. PATIENTS: The success rate and learning curve of a senior nurse placing postpyloric feeding tubes in 50 patients was studied, followed by a study in 160 patients on the success rates and learning curves of 4 inexperienced nurses instructed by the senior nurse. Finally, the success rate of postpyloric feeding tube placement by the senior nurse in 50 critically ill patients was investigated. INTERVENTION: Postpyloric feeding tube positioning by nurses using an electromagnetic universal path-finding system device enabling them to follow the path of the tip of the feeding tube on a monitor screen. MAIN OUTCOME MEASUREMENTS: Success was defined by postpyloric positioning of the feeding tube. The ultimate aim was to reach at least the duodenojejunal flexure. RESULTS: In the first part, the senior nurse was successful in 72% of cases. There was a clear learning curve. In the second part, the 4 newly instructed nurses had a success rate of 89.4% without an evident learning curve. In the third part, successful feeding tube positioning was achieved in 78% of critically ill patients. Of the 217 successfully positioned tubes, 74% reached at least the duodenojejunal flexure. In half of the unsuccessful cases, an explanation for the failure was found at endoscopy. No complications were seen. LIMITATIONS: The generalization to less-specialized hospitals should be investigated. CONCLUSION: Postpyloric positioning of feeding tubes by nurses at the bedside without endoscopy is feasible and safe. Nurses may take over some of the tasks of doctors in a time of high endoscopic needs
AB - BACKGROUND: The early institution of feeding in patients who need postpyloric feeding tubes is often hampered by a limited availability of endoscopists experienced in safe tube positioning. OBJECTIVE: To test the feasibility of having nurses place postpyloric feeding tubes by using a universal path finding system device. DESIGN: Prospective study. SETTING: Academic hospital. PATIENTS: The success rate and learning curve of a senior nurse placing postpyloric feeding tubes in 50 patients was studied, followed by a study in 160 patients on the success rates and learning curves of 4 inexperienced nurses instructed by the senior nurse. Finally, the success rate of postpyloric feeding tube placement by the senior nurse in 50 critically ill patients was investigated. INTERVENTION: Postpyloric feeding tube positioning by nurses using an electromagnetic universal path-finding system device enabling them to follow the path of the tip of the feeding tube on a monitor screen. MAIN OUTCOME MEASUREMENTS: Success was defined by postpyloric positioning of the feeding tube. The ultimate aim was to reach at least the duodenojejunal flexure. RESULTS: In the first part, the senior nurse was successful in 72% of cases. There was a clear learning curve. In the second part, the 4 newly instructed nurses had a success rate of 89.4% without an evident learning curve. In the third part, successful feeding tube positioning was achieved in 78% of critically ill patients. Of the 217 successfully positioned tubes, 74% reached at least the duodenojejunal flexure. In half of the unsuccessful cases, an explanation for the failure was found at endoscopy. No complications were seen. LIMITATIONS: The generalization to less-specialized hospitals should be investigated. CONCLUSION: Postpyloric positioning of feeding tubes by nurses at the bedside without endoscopy is feasible and safe. Nurses may take over some of the tasks of doctors in a time of high endoscopic needs
U2 - https://doi.org/10.1016/j.gie.2009.10.046
DO - https://doi.org/10.1016/j.gie.2009.10.046
M3 - Article
C2 - 20170911
SN - 0016-5107
VL - 71
SP - 728
EP - 736
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 4
ER -