Skip to main content
Log in

Blind bedside insertion of small bowel feeding tubes

  • Original Article
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

The use of Naso-Jejunal (NJ) feeding is limited by difficulty in feeding tube placement. Patients have traditionally required transfer to Endoscopy or Radiology for insertion of small bowel feeding tubes, with clear resource implications. We hypothesised that the adoption of a simple bedside procedure would be effective and reduce cost. Clinical nutrition and nurse specialist personnel were trained in the 10/10/10 method of blind bedside NJ insertion.

Aims

The aims of this prospective study were to evaluate safety, efficaciousness and resource implications of bedside NJ tube insertion.

Methods

A total of 22 patients had 37 NJ tubes inserted in the study period (12 months). The majority were inserted by either a nurse specialist or clinical nutritionist.

Results

Out of the 37 insertions, 32 (86%) were in the correct position. Compared to Endoscopy insertion, this technique saved an estimated €8,353.60 for the duration of the study.

Conclusion

This study demonstrates that the bedside insertion of NJ tubes by clinical nutritionists and nurse specialists is safe, efficacious and highly cost effective.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Graph 1
Graph 2
Graph 3

Similar content being viewed by others

Abbreviations

PN:

Parenteral nutrition

NJ:

Naso-Jejunal

PFA:

Plain film of the abdomen

NPSA:

National Patient Safety Agency

References

  1. O’Farrell A, Allwright S, Toomey D, Bedford D, Conlon K (2007) Hospital admission for acute pancreatitis in the Irish population, 1997 2004: could the increase be due to an increase in alcohol-related pancreatitis? J Public Health (Oxf) 29(4):398–404. doi:10.1093/pubmed/fdm069

    Article  Google Scholar 

  2. McClave SA, Chang WK, Dhaliwal R, Heyland DK (2006) Nutrition support in acute pancreatitis: a systematic review of the literature. JPEN J Parenter Enteral Nutr 30:143–156. doi:10.1177/0148607106030002143

    Article  PubMed  Google Scholar 

  3. Kaushik N, Pietraszewski M, O’ Keefe SJ (2005) Enteral feeding without pancreatic stimulation. Pancreas 31:353–359. doi:10.1097/01.mpa.0000183374.11919.e5

    Article  PubMed  Google Scholar 

  4. Lord LM, Weiser-Maimone A, Pulhamus M, Sax HC (1993) Comparison of weighted vs unweighted enteral feeding tubes for efficacy of transpyloric intubation. JPEN J Parenter Enteral Nutr 17:271–273. doi:10.1177/0148607193017003271

    Article  CAS  PubMed  Google Scholar 

  5. Jimenez LL, Ramage JE (2004) Benefits of post-pyloric enteral access placement by a nutrition support dietitian. Nutr Clin Pract 19:518–522. doi:10.1177/0115426504019005518

    Article  PubMed  Google Scholar 

  6. Cresci G, Martindale RG (2003) Bedside placement of small bowel feeding tubes in hospitalised patients: a new role for the dietitian. Nutrition 19:843–846. doi:10.1016/S0899-9007(03)00163-1

    Article  PubMed  Google Scholar 

  7. Taylor B, Schallom L (2001) Bedside small bowel feeding tube placement in critically ill patients utilising a dietitian/nurse team approach. Nutr Clin Pract 16:258–262

    Article  Google Scholar 

  8. National Patient Safety Agency (2005) How to confirm the correct position of naso-gastric feeding tubes in infants, children and adults. In: Reducing the harm caused by misplacement of naso-gastric feeding tubes. Interim advice for healthcare staff. http://www.npsa.nhs.uk/uk/site/media/documents/857_Insert-final.web.pdf. Accessed 12 Nov 2007

  9. Thurlow PM (1986) Bedside enteral feeding tube placement in to duodenum and jejunum. JPEN J Parenter Enteral Nutr 10(1):104–105. doi:10.1177/0148607186010001104

    Article  CAS  PubMed  Google Scholar 

  10. Welch S, Hanlon M, Waits M, Foulks C (1994) Comparison of four bedside indicators used to predict duodenal feeding tube placement with radiography. JPEN J Parenter Enteral Nutr 18:525–530. doi:10.1177/0148607194018006525

    Article  CAS  PubMed  Google Scholar 

  11. Welch S (1996) Certification of staff nurses to insert enteral feeding tubes using a research-based procedure. Nutr Clin Pract 11:21–27. doi:10.1177/011542659601100121

    Article  CAS  PubMed  Google Scholar 

  12. Powers J, Chance R, Bortenschlagen L, Hottenstein J, Bobel K, Gervasio J, Rodman J, Rodman GH, McNees TS (2003) Bedside placement of small bowel feeding tubes in the intensive care unit. Crit Care Nurse 23(1):16–24

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Duggan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duggan, S., Egan, S.M., Smyth, N.D. et al. Blind bedside insertion of small bowel feeding tubes. Ir J Med Sci 178, 485–489 (2009). https://doi.org/10.1007/s11845-009-0351-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-009-0351-3

Keywords

Navigation