• Ann-Marie Brown, Christine Perebzak, Colleen Handwork, M David Gothard, and Kristine Nagy.
• Ann-Marie Brown was an assistant professor, School of Nursing, University of Akron, and a nurse practitioner, intensive care, Akron Children's Hospital, Akron, Ohio. Brown is now a scientific and operations director, Research Institute, and a nurse practitioner, pediatric intensive care unit, Akron Children's Hospital. Christine Perebzak is a clinical nurse specialist in the emergency department at Akron Children's Hospital. Colleen Handwork is a nurse practitioner in The Heart Center, Akron Children's Hospital. M. David Gothard is a biostatistician and president of BioStats, Inc, in East Canton, Ohio. Kristine Nagy is an education coordinator in the Simulation Center for Safety and Reliability, Akron Children's Hospital. abrown@chmca.org.
• Am. J. Crit. Care. 2017 May 1; 26 (3): 248-254.

BackgroundThe preferred route for providing nutrition in the pediatric intensive care unit is enteral. Placement of postpyloric feeding tubes using an electromagnetic-tipped stylet that emits a signal detected by a device held over the patient's abdomen is effective in adult intensive care units, but has not been well studied in pediatric units.ObjectivesTo determine the effectiveness of the electromagnetic device in reducing the numbers of radiation exposures, intrahospital transports, tubes used, and tube placement attempts in the pediatric intensive care unit.MethodsData from a historical control group were compared with data from a prospective intervention group of patients less than 18 years of age and weighing at least 3 kg who required a postpyloric feeding tube in a 23-bed pediatric intensive care unit. Primary outcome was number of radiation exposures. Independent-samples Student t tests were used to compare the 2 study groups for mean equality; Pearson χ2 tests were used to compare categorical data. Statistical testing was 2-sided, and P less than .05 was considered statistically significant.ResultsOf 73 children (30 in control group, 43 in intervention group), those in the intervention group had a higher success rate at tube placement (P = .009) and fewer radiation exposures (P = .006), intrahospital transports (P = .004), and tubes used (P < .001).ConclusionsSuccessful placement of postpyloric feeding tubes by nurse practitioners was safely enhanced using an electromagnetic device. Establishing users' expertise with the device before studying outcomes may improve effectiveness.©2017 American Association of Critical-Care Nurses.

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