You begin your career in an acute care hospital as a newly licensed RN. During y

Question

You begin your career in an acute care hospital as a newly licensed RN. During your orientation, you observe your preceptor checking gastric feeding tube placement by injecting air and auscultating the abdomen, stopping continuous enteral tube feedings before a patient is turned or repositioned, and routinely inserting rectal tubes for patients with diarrhea. You know that ALL three (3) of these practices are currently NOT supported by nursing evidence. When asked, your preceptor responds, “This is the way we have always cared for patients with tube feedings and diarrhea.” You prepare to talk to this peer about necessary changes in nursing practice.

Address the following: • Choose ONE (1) of the practices described in the scenario.

• Describe how you will address this gap in nursing practice with your preceptor.

Write out exactly what you might say to this RN to professionally address the current evidence for the nursing care of patients.

• Include when and where you would communicate this information

• Consider any additional information you might provide to your preceptor to support changing nursing practice

Explanation / Answer

1.

Auscultation is most common method used in the bedside to check the patency of gastric feeding tube.10 to 30 ml of air to be insufflated and auscult in epigastric region. A hollow sound generated by air blown through the tube is used to determine tube placement in the gastrointestinal tract

2. This can be communicate after or before doing a feeding tube insertion for a patient, and never allow the patient to hear as it is a nonevidenced practice.

3. A similar gurgling over the epigastrium when the tube has been incorrectly placed into tracheobronchial tree, pleural space or osophagus. There are some evidenced practices can be used for the confirmation. For example check ph of gastric content, or take an X ray.

Thanks

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