title: Safe, timely, convenient, and cost-effective: a single-center experience with bedside placement of enteral feeding tubes by midlevel providers using fluoroscopic guidance.
abstract: BACKGROUND
  Enteral feeding tube placement has been performed by nurses, gastroenterologists using endoscopy, and interventional radiologists. We hypothesized that midlevel providers placed feeding tubes at bedside using fluoroscopy safely, rapidly, and cost-effectively.
  
  
  METHODS
  We retrospectively analyzed bedside feeding tube placement under fluoroscopy by trained nurse practitioners. We compared charges for this method with charges for placement by other practitioners.
  
  
  RESULTS
  Nurse practitioners placed 632 feeding tubes in 462 patients. Three hundred seventy-nine placements took place in mechanically ventilated placements. Ninety-seven percent of tubes were positioned past the pylorus. The mean fluoroscopy time was 0.7 ± 1.2 minutes. The mean procedure time was 7.0 ± 5.1 minutes. All tubes were placed within 24 hours of the request. There were no complications. Institutional charges for tube placement were $149 for nurse practitioners, $226 for gastroenterologists, and $328 for interventional radiologists.
  
  
  CONCLUSIONS
  The placement of feeding tubes under fluoroscopy by nurse practitioners is safe, timely, and cost-effective.
authors.affiliation: Department of Surgery, Section of Burns/Trauma/Critical Care, University of Utah Hospitals and Clinics, 30 North 1900 East, SOM 3B310, Salt Lake City, UT 84132, USA.
authors.forename: Tricia B
authors.initials: TB
authors.lastname: Hauschild
authors.forename: Katy Y
authors.initials: KY
authors.lastname: Fu
authors.forename: Randall C
authors.initials: RC
authors.lastname: Hipwell
authors.forename: Gabriele
authors.initials: G
authors.lastname: Baraghoshi
authors.forename: Mary C
authors.initials: MC
authors.lastname: Mone
authors.forename: Raminder
authors.initials: R
authors.lastname: Nirula
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Kimball
authors.forename: Richard G
authors.initials: RG
authors.lastname: Barton
mesh_terms: D003362:Cost-Benefit Analysis; D004750:Enteral Nutrition / Q000191:economics / Q000295:instrumentation / Q000379:methods / Q000451:nursing*; D005260:Female; D005471:Fluoroscopy / Q000191:economics / Q000451:nursing; D017722:Hospital Charges; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000191:economics / Q000295:instrumentation / Q000379:methods / Q000451:nursing*; D008297:Male; D009722:Nurse Practitioners; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D013997:Time Factors; D014589:Utah