Nasoenteral feeding tube placement: indications and nurse skills

Introduction

Nutrition therapy (NT) is a powerful tool to assist the patients' nutritional needs mainly in the ICU, where the patients usually have high energy expenditures. The route mostly used for NT is the nasoenteral feeding tube (NFT), being easier and with lower costs. It can be accomplished by the nursing staff under direct vision by the nasal route (after training) or through endoscopy. The nasoenteral insertion is not free from complications, and these can be classified as: mechanics (obstruction of the probe, accidental exit, migration of the tube), infectious and psychological (anxiety, depression). The NFT is suitable for small and medium periods of NT (about 6 weeks).

Objectives

To classify the indication of the NFT in the ICU; to identify the complications and the professional that accomplished the insertion.

Results

During the period from January 2005 to 23 February 2005 we studied 83 patients receiving NT, 49% of them male. Successful first introduction was achieved in 35 patients (42%). The indication of NFT was NT in 98% of cases: 58% of them were replaced, and the reasons were 16 obstructions of the tube (33%), 17 accidental exits (35%) and 15 migrations (32%). The nursing staff accomplished the tube insertion 80% of times. There were 5% with complications; all of them were nasal bleeding, considered a minor complication.

Conclusion

The main reason for NFT insertion was NT initiation. Nursing staff have great capability for tube placement and we identify clear requests for improvement interventions to avoid a large number of tube replacements.