Examination of gavage tube placement in children

Abstract

Issues and purpose: A primary issue in ensuring safe and effective enteral feeding by tube is achieving and maintaining correct tube position. This study was conducted to determine the prevalence of tube placement errors, risk factors associated with these errors, and accuracy of commonly used bedside placement-screening methods.

Design and methods: In this descriptive study, 39 hospitalized children having one or more types of enteral tubes were studied prospectively. Tube placement was assessed across time, using three common placement-screening methods compared to radiographs.

Results: Tube placement error occurred in 43.5% of tubes at least once during the observation period. Children who were comatose or semicomatose, were inactive, had swallowing problems, or had Argyle tubes were more likely to have tube placement errors.

Practice implications: Findings suggest that radiographs to document tube placement may be needed, at least on initial enteral tube insertion.