title: Current Practices in Home Management of Nasogastric Tube Placement in Pediatric Patients: A Survey of Parents and Homecare Providers.
abstract: Enteral feeding tubes are used in pediatric patients to deliver nutrition, fluids or medications. The literature related to short-term feeding tube (nasogastric [NG], hereafter known as NGT, or orogastric [OGT],) use in pediatric homecare patients is sparse. This descriptive study sought to gather baseline information about these children and how their feeding tubes are managed at home. Specifically, we sought to better understand how the tubes are placed and the method(s) used for tube placement verification. Two surveys were distributed: one to parents and one to homecare providers who have direct patient contact.
  
  
  RESULTS
  Responses were obtained from 144 parents and 66 homecare providers. Over half of the children were 12months of age or younger and had a 6 Fr feeding tube. Over 75% (108) had an NGT for 1year or less. Predominantly parents replaced the NGT but a few children self-inserted their tubes. Feeding tube placement was verified by auscultation (44%) or measurement of gastric pH (25%) in the parent's survey. Twenty-six percent of parents indicated they had misplaced an NGT at least once and 35 parents described symptoms of pulmonary misplacement. The homecare provider data indicated auscultation (39%) and pH measurement of gastric contents (28%) to verify NG tube placement location. Study results confirms a need for consistency of practice among health care professionals and in parent education for those children who require NGTs at home. It is troubling that auscultation is still widely used for NGT location confirmation despite practice alerts that warn against its use.
authors.affiliation: University of Mississippi Medical Center School of Nursing, 2500 North State Street, Jackson, MS 39216, USA. Electronic address: lnorthington@umc.edu.
authors.forename: LaDonna
authors.initials: L
authors.lastname: Northington
authors.affiliation: Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108, USA. Electronic address: blyman@cmh.edu.
authors.forename: Beth
authors.initials: B
authors.lastname: Lyman
authors.affiliation: American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), 8630 Fenton St. Suite 412, Silver Spring, MD 20910, USA. Electronic address: peggig@nutritioncare.org.
authors.forename: Peggi
authors.initials: P
authors.lastname: Guenter
authors.affiliation: University of Pennsylvania, School of Nursing, Claire M. Fagin Hall, 418 Curie Blvd., RM 427, Philadelphia, PA 19104, USA. Electronic address: ysha@nursing.upenn.edu.
authors.forename: Sharon Y
authors.initials: SY
authors.lastname: Irving
authors.affiliation: Pediatric Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. Electronic address: lduesing@mcw.edu.
authors.forename: Lori
authors.initials: L
authors.lastname: Duesing
mesh_terms: D017028:Caregivers / Q000193:education / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006699:Home Care Services; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D064691:Nurses, Community Health; D010290:Parents / Q000193:education*; D061214:Patient Safety; D016896:Treatment Outcome; D014481:United States
keywords: Home setting; NGT placement; NGT verification; NGT(s); Parents