Lindsey Bloom, DNP, RN, CCRN, SCRN
Maureen A. Seckel, MSN, RN, APRN, ACNS-BC, CCNS, CCRN
Published at AACN Advanced Critical Care Volume 33, Number 1, pp. 68-84
Placement of Nasogastric Feeding Tube and Postinsertion Care Review by Bloom and Seckel appeared in ACCN Critical in March 2022 provides another comprehensive review of the methods of placement as well as the technology available on the market today.
In the article Bloom and Seckel describe feeding tube complications related to insertion and postinsertion care.
They list the different insertion models and summarize ESPEN, ASPEN and ACG guidelines.
Lastely, they describe the available methods for NG Feeding Tube Insertion and Confirmation
“Insertion and postinsertion care of enteral nasogastric feeding tubes are common procedures in the United States, with more than 1.2 million temporary nasogastric feeding tubes inserted annually. Although there are some evidence-based practice guidelines and recommendations for care of these tubes, variation in practice still exists. Additional research is needed to determine the best methodology for insertion and confirmation of nasogastric feeding tubes. Routine competency and training on feeding tube insertion, enteral nutrition, and postinsertion care is crucial to prevent patient safety events. Variable results have been reported with different technologies; however, radiographic confirmation remains the criterion standard. It is important that health care institutions develop standardized procedures for insertion and confirmation on the basis of evidence-based practices to minimize risks and complications from temporary nasogastric feeding tubes.”
“Enteral FTs are an important tool in the care of patients in acute care today, and much of the enteral FT–related assessment, monitoring, and care is completed by nurses. Every health care facility or system should have a procedure or protocol for the insertion and care of enteral FTs based on evidence-based guidelines. Although there are many methodologies for insertion per device or procedure, all staff inserting these tubes should have the prerequisite training and competencies based on manufacturer and institutional guidelines.
The risk of complications should be mitigated as much as possible and performance improvement data reviewed for any opportunities.
Furthermore, the United States is in transition currently to adopt the new ENFit connectors, so now is an opportune time to review NG tube standards of care in every facility.”