{"title":"A Nurse-Driven Protocol for Neonatal Enteral Access Device Placement Confirmation.","authors":"Kim V Cooley, Patricia W Denning","doi":"10.1097/ANC.0000000000001186","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Preterm infants require the use of nasogastric and orogastric enteral access devices (EADs) to provide nutrition and medications. Confirmation of the location of the tip of the EAD is essential to minimize complications. At the study site, EAD location was limited to verifying the centimeter marking at the lip/nares and nonevidence-based methods of visual observation of aspirate and auscultation.</p><p><strong>Purpose: </strong>Implement an evidenced-based EAD placement confirmation protocol, and by 90 days post-education and implementation, achieve adherence of 90%.</p><p><strong>Methods: </strong>This quality improvement project implemented a nurse-driven evidence-based protocol for EAD verification. The intervention was based on the New Opportunities for Verification of Enteral Tube Location best practice recommendations. Prior to implementation, education sessions focused on insertion measurement technique and gastric pH measurement. Radiographs, insertion measurement technique, centimeter marking, and gastric pH measurement were used for EAD location confirmation. To determine compliance with the protocol, audits were conducted and questionnaires assessing current practice regarding EAD confirmation were administered pre- and postimplementation.</p><p><strong>Results: </strong>The protocol increased nursing knowledge regarding evidence-based EAD insertion and verification procedures, incorporated pH measurement into practice, and reduced use of auscultation for confirmation. Nursing adherence to the protocol was 92%.</p><p><strong>Implications for practice and research: </strong>This provides a model for how to successfully implement and achieve adherence to an evidence-based EAD placement confirmation nurse-driven protocol. Further research is needed to verify the effectiveness of the protocol and establish consensus on approaches specifically for the neonatal population.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"324-332"},"PeriodicalIF":1.6000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Neonatal Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ANC.0000000000001186","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Preterm infants require the use of nasogastric and orogastric enteral access devices (EADs) to provide nutrition and medications. Confirmation of the location of the tip of the EAD is essential to minimize complications. At the study site, EAD location was limited to verifying the centimeter marking at the lip/nares and nonevidence-based methods of visual observation of aspirate and auscultation.
Purpose: Implement an evidenced-based EAD placement confirmation protocol, and by 90 days post-education and implementation, achieve adherence of 90%.
Methods: This quality improvement project implemented a nurse-driven evidence-based protocol for EAD verification. The intervention was based on the New Opportunities for Verification of Enteral Tube Location best practice recommendations. Prior to implementation, education sessions focused on insertion measurement technique and gastric pH measurement. Radiographs, insertion measurement technique, centimeter marking, and gastric pH measurement were used for EAD location confirmation. To determine compliance with the protocol, audits were conducted and questionnaires assessing current practice regarding EAD confirmation were administered pre- and postimplementation.
Results: The protocol increased nursing knowledge regarding evidence-based EAD insertion and verification procedures, incorporated pH measurement into practice, and reduced use of auscultation for confirmation. Nursing adherence to the protocol was 92%.
Implications for practice and research: This provides a model for how to successfully implement and achieve adherence to an evidence-based EAD placement confirmation nurse-driven protocol. Further research is needed to verify the effectiveness of the protocol and establish consensus on approaches specifically for the neonatal population.
期刊介绍：
Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features.
Each issue offers Continuing Education (CE) articles in both print and online formats.
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