Use of Electromagnetic Device to Insert Postpyloric Feeding Tubes in a Pediatric Intensive Care Unit.

Autor:	Brown AM; 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., Perebzak C; 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., Handwork C; 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., Gothard MD; 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., Nagy K; 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.
Jazyk:	angličtina
Zdroj:	American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2017 May; Vol. 26 (3), pp. 248-254.
DOI:	10.4037/ajcc2017202
Abstrakt:	Background: The 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. Objectives: To 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. Methods: Data 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 χ 2 tests were used to compare categorical data. Statistical testing was 2-sided, and P less than .05 was considered statistically significant. Results: Of 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). Conclusions: Successful 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.)
Databáze:	MEDLINE
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