NURSING MANAGEMENT OF ENTERAL TUBE FEEDINGS

OBJECTIVE: To describe the management practices of nurses when providi ng care to patients receiving enteral tube feedings. DESIGN: A descrip tive study was conducted with use of questionnaires distributed to reg istered nurses (RNs). SETTING: A midwestern university medical center. SAMPLE: A total of 235 questionnaires were distributed to RNs. Two hu ndred nineteen were considered eligible and 180 were usable. This repr esents an 82% response. METHOD: A 43-item questionnaire with a return envelope was placed in the mailbox of RNs. DATA ANALYSIS: Descriptive statistics were used to analyze data. RESULTS: (1) Checking the now ra te of enteral feeding: Flow rates were checked between 1 to 4 hours by 70% of the nurses, whereas 16% checked every 8 hours, and the remaini ng 14% checked every 12 hours or longer. (2) Flushing the enteral tube : Ninety-four percent of respondents indicated they regularly flushed the enteral tube before each feeding (29%), after each feeding (43%), and every 4 hours (59%). The types of irrigants that were used for flu shing included tap water, sterile water, and sterile normal saline sol ution. (3) Method of unclogging obstructed tubes: An irrigant solution Is the primary intervention reported by nurses to unclog tubes (94%). The types of solutions reportedly used most frequently were carbonate d beverage (81%), sterile water (49%), dissolved papain (46%), and tap water (42%), (4) Checking residuals: Most RNs (95%) reported that the y check residuals every 4 hours; of these, 50% stated they discard res iduals, and 49% stated that they readminister residuals. In regard to the volume of residual deemed to be excessive, 50% of the respondents stated that an amount greater than or equal to 100 ml is excessive. (5 ) Administering medications: Flushing the enteral tube with water is r eported to be done before (47%) and after (95%) giving medicines. When multiple medicines are given, 38% report flushing the enteral tube be tween each medication. CONCLUSION: The findings of this self-report st udy suggest that practices regarding management of enteral feedings va ry widely among nurses.