Development and evaluation of standardized protocol to prevent nasoenteral tube obstruction in cardiac patients requiring enteral nutrition with restricted fluid volumes

Abstract

This study sought to assess the impact of a standardized protocol to maintain nasoenteral tube (NET) patency in patients requiring fluid restriction and identify factors associated with tube patency. Nasoenteral tube obstruction may interrupt nutritional support and prohibit drug administration. Balancing NET patency in the context of fluid restriction can be a challenge. The impact of the standardized protocol was assessed by using a quasi-experimental design and an historical control. Sixty patients receiving nasoenteral feeding as part of their clinical management were enrolled in the study. Nasoenteral obstruction was 8.3%, showing a reduction from the 17.4% observed in the baseline data collection. A key factor associated with tube obstruction was sounding of an infusion pump alarm reflecting the tube patency issues. While mindful of the limitations of probability sampling, the implementation of a standardized protocol accompanied by staff training reduced the rates of NET obstruction. On the basis of these findings, we conclude that it is possible to maintain the patency of small bore tubes, even in the presence of fluid restriction, with a standardized protocol to guide clinical management.