Kaylee Allan1, Stephen Taylor2, Rowan Clemente1, Deirdre Toher3. 1. Nutrition Support Dietitian, Department of Nutrition and Dietetics, Southmead Hospital, Bristol. 2. Research Dietitian, Department of Nutrition and Dietetics, Southmead Hospital, Bristol. 3. Statistician, Department of Engineering, Design and Mathematics, University of the West of England, Bristol.
Abstract
BACKGROUND: safe placement and securement of feeding tubes are essential to establishing early enteral nutrition. Nasogastric or nasojejunal feeding tubes are often inadvertently removed, and using a nasal bridle can reduce the number of tube replacements required. AIM: to review current nasal bridle practices on one intensive care unit. Over a 3-month period, nasal bridle use was recorded to measure unintentional tube loss and tube duration (the time a tube remained in situ). METHOD: an observational service evaluation. FINDINGS: 109 patients were recruited; 205 tubes were passed and 77 bridles were inserted, with 42% (n=46) of the bridles placed on day 1. Tubes secured with tape were more likely to be dislodged than tubes secured with a bridle, P=0.0001. Duration of tubes remaining in situ was significantly longer in patients who had a bridle fitted on day 1, P=0.0001 compared with tubes secured with tape. CONCLUSION: securing a tube with a nasal bridle from day 1 is independently associated with reduced tube loss, increased duration of tube use, and likelihood that the tube would reach redundancy when it was no longer required.
BACKGROUND: safe placement and securement of feeding tubes are essential to establishing early enteral nutrition. Nasogastric or nasojejunal feeding tubes are often inadvertently removed, and using a nasal bridle can reduce the number of tube replacements required. AIM: to review current nasal bridle practices on one intensive care unit. Over a 3-month period, nasal bridle use was recorded to measure unintentional tube loss and tube duration (the time a tube remained in situ). METHOD: an observational service evaluation. FINDINGS: 109 patients were recruited; 205 tubes were passed and 77 bridles were inserted, with 42% (n=46) of the bridles placed on day 1. Tubes secured with tape were more likely to be dislodged than tubes secured with a bridle, P=0.0001. Duration of tubes remaining in situ was significantly longer in patients who had a bridle fitted on day 1, P=0.0001 compared with tubes secured with tape. CONCLUSION: securing a tube with a nasal bridle from day 1 is independently associated with reduced tube loss, increased duration of tube use, and likelihood that the tube would reach redundancy when it was no longer required.