Get access

Successful blind placement of nasojejunal tubes in paediatric intensive care: impact of training and audit

Authors

  • Rosan Meyer,

    1. Rosan Meyer BDiet PGDipDiet MNutrition
      Paediatrics Research Dietician
      Department of Paediatrics, Division Medicine, Imperial College, St Mary’s Campus, London, UK
    Search for more papers by this author
  • Stephanie Harrison,

    1. Stephanie Harrison Msc RN RSCN
      Lead Nurse
      Paediatric Intensive Care Unit, St Mary’s Hospital, London, UK
    Search for more papers by this author
  • Mehrengise Cooper,

    1. Mehrengise Cooper FRCPCH
      Intensivist Paediatric Consultant
      Paediatric Intensive Care Unit, St Mary’s Hospital, London, UK
    Search for more papers by this author
  • Parviz Habibi

    1. Parviz Habibi PhD FRCP FRCPCH
      Intensivist Paediatric Consultant
      Department of Paediatrics, Division Medicine, Imperial College, St Mary’s Campus, London, UK
    Search for more papers by this author

Rosan Meyer:
e-mail: rmeyer@imperial.ac.uk

Abstract

Title. Successful blind placement of nasojejunal tubes in paediatric intensive care: impact of training and audit

Aim.  This paper is a report of a study to monitor continuing nasojejunal tube placement success rate and to evaluate a training programme for staff placing these tubes at the bedside.

Background.  Gastric delivery of enteral feeds is frequently poorly tolerated due to impaired gastric motility in critically ill children. Consequently, there has been an increased interest in the use of the nasojejunal feeding route. Nasojejunal tubes are both safe and well-tolerated, but placements of these tubes are notoriously difficult and therefore often avoided. Consequently, a blind bedside technique was developed, with a placement success of 96%.

Method.  A training programme using this technique was developed for nursing staff on the unit. This included one-to-one training of key nurses of the nasojejunal tube placement technique and a supervised nasojejunal placement with either the senior nurse or dietitian. This practice was audited in 100 consecutive patients in 2001 and 2004. Patient demographics, diagnosis, time taken for placement and reasons for unsuccessful placements were documented.

Results.  The 2001 audit (n = 100) indicated that the nasojejunal route was used in 19% of all cases, with 1% and 80% of patients fed via the parenteral and nasogastric route respectively. In 2004 (n = 94), 18% of patients were fed via the nasojejunal route, 3% parenterally and 79% via the gastric route. Placement success continued to be between 94·5–95% in 2001 and 2004.

Conclusion.  Continued successful placement of blind nasojejunal feeding tubes can be achieved through a well-monitored education programme, regular audit cycles and multidisciplinary team support.

Get access to the full text of this article

Ancillary