• Rosan Meyer, Stephanie Harrison, Mehrengise Cooper, and Parviz Habibi.
• Department of Paediatrics, Division Medicine, Imperial College, St Mary's Campus, London, UK. rmeyer@imperial.ac.uk
• J Adv Nurs. 2007 Nov 1;60(4):402-8.

AimThis 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.BackgroundGastric 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%.MethodA 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.ResultsThe 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.ConclusionContinued successful placement of blind nasojejunal feeding tubes can be achieved through a well-monitored education programme, regular audit cycles and multidisciplinary team support.

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