Reducing Lung Injury from Blind Insertion of Small-Bore Feeding Tubes.

Autor:	Jahn T; Teresa Jahn is an advanced practice nurse at CentraCare Heart and Vascular Center, St. Cloud Hospital, St. Cloud, MN, where Jenelle Overgaard is a nurse clinician in the ICU, Mallory Mondloch is a nurse clinician in the surgical care unit, Elizabeth Plante is a nurse clinician in the neuroscience/spine unit, Jennifer Burris is director of inpatient and outpatient nursing practice and innovation, and Mithun Suresh is a hospitalist. Jodi Berndt is associate professor at the College of Saint Benedict and Saint John's University, St. Joseph, MN. Contact author: Teresa Jahn, jahnteresa@hotmail.com . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise., Overgaard J, Mondloch M, Plante E, Burris J, Suresh M, Berndt J
Jazyk:	angličtina
Zdroj:	The American journal of nursing [Am J Nurs] 2024 Jul 01; Vol. 124 (7), pp. 28-34. Date of Electronic Publication: 2024 Jun 20.
DOI:	10.1097/01.NAJ.0001025188.79366.be
Abstrakt:	Abstract: Using a blind insertion technique to insert small-bore feeding tubes can result in inadvertent placement in the lungs, leading to lung perforation and even mortality. In a Magnet-designated, 500-bed, level 2 trauma center, two serious patient safety events occurred in a four-week period due to nurses blindly inserting a small-bore feeding tube. A patient safety event review team convened and conducted an assessment of reported small-bore feeding tube insertion events that occurred between March 2019 and July 2021. The review revealed six lung perforations over this two-year period. These events prompted the creation of a multidisciplinary team to evaluate alternative small-bore feeding tube insertion practices. The team reviewed the literature and evaluated several evidence-based small-bore feeding tube placement methods, including placement with fluoroscopy, a two-step X-ray, electromagnetic visualization, and capnography. After the evaluation, capnography was selected as the most effective method to mitigate the complications of blind insertion. In this article, the authors describe a quality improvement project involving the implementation of capnography-guided small-bore feeding tube placement to reduce complications and the incidence of lung perforation. Since the completion of the project, which took place from December 13, 2021, through April 18, 2022, no lung injuries or perforations have been reported. Capnography is a relatively simple, noninvasive, and cost-effective technology that provides nurses with a means to safely and effectively insert small-bore feeding tubes, decrease the incidence of adverse events, and improve patient care. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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