Use of Temporary Enteral Access Devices in Hospitalized Neonatal and Pediatric Patients in the United States

Background: Temporary enteral access devices (EADs), such as nasogastric (NG), orogastric (OG), and postpyloric (PP), are used in pediatric and neonatal patients to administer nutrition, fluids, and medications. While the use of these temporary EADs is common in pediatric care, it is not known how often these devices are used, what inpatient locations have the highest usage, what size tube is used for a given weight or age of patient, and how placement is verified per hospital policy. Materials and Methods: This was a multicenter 1‐day prevalence study. Participating hospitals counted the number of NG, OG, and PP tubes present in their pediatric and neonatal inpatient population. Additional data collected included age, weight and location of the patient, type of hospital, census for that day, and the method(s) used to verify initial tube placement. Results: Of the 63 participating hospitals, there was an overall prevalence of 1991 temporary EADs in a total pediatric and neonatal inpatient census of 8333 children (24% prevalence). There were 1316 NG (66%), 414 were OG (21%), and 261 PP (17%) EADs. The neonatal intensive care unit (NICU) had the highest prevalence (61%), followed by a medical/surgical unit (21%) and pediatric intensive care unit (18%). Verification of EAD placement was reported to be aspiration from the tube (n = 21), auscultation (n = 18), measurement (n = 8), pH (n = 10), and X‐ray (n = 6). Conclusion: The use of temporary EADs is common in pediatric care. There is wide variation in how placement of these tubes is verified.     

Listening as a method of addressing psychological distress

Aims  This paper discusses the values of therapeutic listening and ways that emotional difficulties can impact palliative nurses' abilities to provide psychological care.
Background  Recent literature indicates that providing psychological care can burden some healthcare professionals including nurses; who may lack the necessary competencies or organizational resources to carry out their roles.
Evaluation  References drawn from the databases: all EBM reviews, BRITISH NURSING INDEX, CINAHL, PSYCH INFO and MEDLINE and EMBASE are discussed.
Key issues  Psychological care is considered critical to providing holistic care. Yet the literature suggests engaging in such work makes emotional demands on the professionals attempting to carry it out and is associated with psychological difficulties including burnout.
Conclusion  Clinical supervision can help reduce the distress caused by emotionally charged situations. Thoughtful clinical supervision can also contribute to safe and effective health care.
Implications for Nursing Management  Nursing would benefit from understanding more about the effects on healthcare professionals of repeated exposure to emotionally charged situations and benefits that clinical supervision can offer to health care.