How Safe Are Your Enteral Feeding Practices? (101)

Abstract Text: Due to prematurity and critical illness, over 90% of infants admitted to neonatal intensive care units (NICU) will require placement of orogastric/nasogastric feeding tubes (FTs) and will continue to require FTs for weeks to months. Both FT insertion and placement verification in the NICU is often performed using non-evidence based methods and confusion exists regarding the evidence behind both methods of insertion and verification. Use of non-evidenced based methods increases the risk of malpositioning which is known to cause serious and potentially life-threatening complications. Furthermore, the length of time FTs remain in place may increase the number of potentially pathogenic bacteria present in the FT lumen, potentially increasing the risk of adverse health outcomes. Yet protocols regarding FT dwell time are often not evidence based. These clinical dilemmas not only affect the everyday work life of clinical nurses but the outcomes of using non-evidence-based practices can affect infants and their families for years to come. This session will discuss these clinical dilemmas and their significance in the context of what we know, what we do not know, and what we need to know. In addition, concepts of de-implementation science and changing practice will be presented.

Needs Assessment and Presentation Description: Orogastric/nasogastric feeding is indispensable for preterm infants and sick term newborn infants. However, feeding tube practice dilemmas and their significance in the context of what we know, what we do not know, and what we need to know remain prevalent. Likewise, concepts of de-implementation science, nurse-led research and application of evidence-based practice must be operationalized.