Microbiome profile informs cleansing and storage practices for reusable feeding tube stylets in critical care.

Background: Cleansing and storage practices for reusable feeding tube stylets are varied and lack consensus guidelines. Almost 40% of critical care nurses do not cleanse reusable stylets. Our proof-of-concept study aimed to identify potential microbial contamination of stylets before and after cleansing with 70% isopropyl alcohol to establish practice standards.

Migration of Feeding Tubes Assessed by Using an Electromagnetic Device: A Cohort Study.

Background: Bedside methods to verify placement of a feeding tube are not accurate for detecting placement within the gastrointestinal tract, increasing risk of pulmonary aspiration. Current guidelines recommend verifying placement every 4 hours, yet the rationale for this recommendation is unknown.

Objective: To assess spontaneous migration of small-bore feeding tubes in critically ill adults.

National Survey of Feeding Tube Verification Practices: An Urgent Call for Auscultation Deimplementation.

Background: Harm events such as pneumothoraces and pneumonia continue to be associated with feeding tube insertion. Most bedside verification methods are not accurate to discriminate pulmonary from gastrointestinal system. Evidence-based clinical practice guidelines do not support auscultation of feeding tubes in adults, yet auscultation is the most common method used.

Pneumothoraces Prevented With Use of Electromagnetic Device to Place Feeding Tubes.

Background: A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic placement devices that provide real-time visualization of feeding tube position.

Objectives: To systematically assess pulmonary placement and pneumothoraces in CORTRAK-assisted feeding tube insertions.

Methods: CINAHL, MEDLINE, and Cochrane databases were searched for studies of CORTRAK-assisted feeding tube insertion.

CORTRAK Superuser Competency Assessment and Training Recommendations.

Background: Blind insertion of feeding tubes remains unsafe. Electromagnetic placement devices such as the CORTRAK Enteral Access System allow operators to interpret placement of feeding tubes in real time. However, pneumothoraces have been reported and inadequate user expertise is a concern.

Varying levels of fidelity on psychomotor skill attainment: a CORTRAK product assessment.

Background: A task trainer is defined . Concepts for consideration when selecting a task trainer include fidelity and cognitive load. Insertion of small - bore FTs in acutely ill patients continues to be a high - risk skill.

Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device.

Background: Early enteral nutrition has been shown to decrease complications and improve patient outcomes. Post pyloric feeding is recommended for patients with gastric intolerance or at high risk for aspiration. Feeding tube placement can be challenging and pose risk of pulmonary complications.

Cortrak-Assisted Feeding Tube Insertion: A Comprehensive Review of Adverse Events in the MAUDE Database.

Background: Electromagnetic devices to guide feeding tube placement such as the CORTRAK Enteral Access System have shown promising results; however, researchers in recent studies have expressed concern that a higher level of user expertise may be required for safe use.

Objectives: To review adverse events related to CORTRAK-assisted feeding tube insertion reported in the Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database.

Methods: A retrospective, secondary analysis of the MAUDE database was performed to evaluate adverse events (ie, injury or death of patient) related to CORTRAK.

Finding the right fit: implementation of a structured interviewing process for clinical nurse specialists.

Purpose And Background: The purpose of this article is to describe how clinical nurse specialists (CNSs) in one organization developed a structured interviewing process for CNS candidates. The process has evolved in relation to implementation of national CNS competencies, growth of the role in the organization, and changes to reporting structure.

Outcomes: The CNS interview process includes panel interviews with various organizational leaders, CNSs, and team members.