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Situational Analysis

 

Medical research statistics state that on average feedings tubes are improperly placed or move out of place 40% of the time. (1,2,3,4)

 

Feeding tubes are routine medical treatment for a human or animal that cannot eat enough orally to sustain themselves.  Temporary feeding tubes are blindly placed via the nose or mouth and advanced down the esophagus and end in the stomach.  These tubes are made of different types of plastic based on comfort and the amount of time tube feedings need to be administered.  There is a great deal of discomfort with nasal or oral feeding tubes.  The current evidence based nursing research is recommending X-rays for all feeding tube placements.  The X-ray method may increase accuracy but adds increased radiation exposure and costs to patients and institutions where this form of treatment is available.

 

In 2010, an estimated 8.1 million babies required a feeding tube for survival.  With misplacement rates at 40%, over 3 million babies experienced improperly placed feeding tubes and 2% or 162,000 feeding tubes were placed in babies respiratory systems.

 

The incidence of airway misplacement of feeding tubes (3.2%) at a majority tertiary referral university was alarming.  Mandatory radiographs may eliminate the risk of respiratory administration of feedings but not misplacements.  The associated costs of radiographs, unsuccessful placements, fluoroscopy, and complications are significant.  A solution to this problem will require focused attention and development of specific protocols, possibly using new technologies.  (2007, Nascimento & Kudsk)

 

The Illinois Law Bulletin from June 2012 states "An Illinois settlement awarded the parents of a premature baby $12,500,000 after the feeding tube was improperly placed and formula was instilled in the infant's lungs."  The baby survived but sustained lifelong brain damge from a lack of oxygen to the brain.








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