I would like to know other hospitals policies on inserting small bowel feeding tubes. The way it's been for several years goes like this...Typically, if a doctor writes an order "Radiology to insert small bowel feeding tube", we have the floor nurse try to get the tube into the stomach at least first. Then patient comes down and is advanced under flouro by the rad nurse and radiologist looks at the pic and says if it's ok or not. If a nurse can't get it, we will usually just try it ourselves. HOWEVER, the problem is, the policy states "if a physician wishes to ensure exact placement of the feeding tube within the small bowel, there are 2 alternatives (1) the tube can be placed under fluoroscopy by a Radiologist or (2) GI physican can do using endoscopy". So I now belive that rad nurses should not be doing this under flouro at all. The nurses don't run the flouro equipment (rad techs do that) and nurse are not officially trained to know what we are looking at as we advance the tube. So, I'm having a big problem with this whole thing. What do you think? What are your policies? I'm worried about liability if a drop a lung or something else happens. By the way, our feeding tube policy does state that all floor nurses can insert small bowel feeding tubes and get xray to check placement. They only order them for radiology when they are really difficult. Any comments would be appreciated. This is my first posting. Thanks
May 21, '08
I have similiar queston. I can tell you that 20 years ago I was trained to place weighted small bore feeding tube but that I was the only one and went thru very thorough training. I am in an extensive lit search without much success. It seems most today recomend that these are place fluroscopically or with new endscopic tube. To me this is phyhsican practice but nurses in several insititutions here do place PICC lines in Radiology. Is this not a similair practice? I think if insertion is by an RN that RN needs to be trained and complete a comeptancy on this skill. The RN under our state pracitice acts is performing a function delegated by the physician so the hospital would assume liablity. Please let me know if you find any other more concrete practice guidelines.