title: Development and evaluation of standardized protocol to prevent nasoenteral tube obstruction in cardiac patients requiring enteral nutrition with restricted fluid volumes.
abstract: OBJECTIVE
  This study sought to assess the impact of a standardized protocol to maintain nasoenteral tube (NET) patency in patients requiring fluid restriction and identify factors associated with tube patency.
  
  
  BACKGROUND
  Nasoenteral tube obstruction may interrupt nutritional support and prohibit drug administration. Balancing NET patency in the context of fluid restriction can be a challenge.
  
  
  METHODS
  The impact of the standardized protocol was assessed by using a quasi-experimental design and an historical control.
  
  
  RESULTS
  Sixty patients receiving nasoenteral feeding as part of their clinical management were enrolled in the study. Nasoenteral obstruction was 8.3%, showing a reduction from the 17.4% observed in the baseline data collection. A key factor associated with tube obstruction was sounding of an infusion pump alarm reflecting the tube patency issues.
  
  
  CONCLUSIONS
  While mindful of the limitations of probability sampling, the implementation of a standardized protocol accompanied by staff training reduced the rates of NET obstruction.
  
  
  CONCLUSIONS
  On the basis of these findings, we conclude that it is possible to maintain the patency of small bore tubes, even in the presence of fluid restriction, with a standardized protocol to guide clinical management.
authors: Intensive Care Unit, Federal University of São Paulo, Hospital do Coração/Associação do Sanatório Sírio, São Paulo, Brazil. csmatsuba@uol.com.br
authors: Claudia St
authors: CS
authors: Matsuba
authors: Maria Gr
authors: MG
authors: De Gutiérrez
authors: Iveth Y
authors: IY
authors: Whitaker
mesh_terms: D001938:Brazil; D002626:Chemistry, Pharmaceutical; D015400:Clinical Nursing Research; D002985:Clinical Protocols / Q000592:standards*; D003422:Critical Care / Q000379:methods; D004358:Drug Therapy / Q000451:nursing; D064420:Drug-Related Side Effects and Adverse Reactions; D004509:Education, Nursing, Continuing; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation / Q000451:nursing*; D004868:Equipment Failure / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D018565:Food-Drug Interactions; D006331:Heart Diseases / Q000628:therapy; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000451:nursing*; D008297:Male; D009730:Nursing Assessment / Q000592:standards; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education; D010347:Patient Care Planning / Q000592:standards*; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000379:methods / Q000451:nursing* / Q000592:standards