Miller, J., Drummond Haye, D., & Carey, K. W. (2015). 20 QUESTIONS: Evidence-bas
ID: 128791 • Letter: M
Question
Miller, J., Drummond Haye, D., & Carey, K. W. (2015). 20 QUESTIONS: Evidence-based practice or sacred cow? Nursing, 45(8), 46-55. doi:10.1097/01.NURSE.0000469234.84277.95
Scenario:
You begin your career in an acute care hospital as a newly licensed RN. During your orientation, you observe your preceptor checking gastric feeding tube placement by injecting air and auscultating the abdomen, stopping continuous enteral tube feedings before a patient is turned or repositioned, and instilling normal saline solution before endotracheal suctioning. You know that ALL three (3) of these practices are currently NOT supported by nursing evidence. When asked, your preceptor responds, “This is the way we have always cared for patients with tube feedings and diarrhea.” You prepare to talk to this peer about necessary changes in nursing practice.
Initial Discussion Post:
Address the following:
Choose ONE (1) of the practices described in the scenario.
Describe how you will address this gap in nursing practice with your preceptor. Write out exactly what you might say to this RN to professionally address the current evidence for the nursing care of patients.
Include when and where you would communicate this information.
Consider any additional information you might provide to your preceptor to support changing nursing practice.
Explanation / Answer
1. scenario: checking gastric feeding tube placement by injecting air.
2,Addressing the issue:
Nursing is an art and science. We are supposed to do any practice with an evidence based on research. Because evidence based practice enhances delivery of quality care. Then for what reason we have practising the method of
checking gastric feeding tube placement by injecting air. Eventhough it is been practiced traditionally another method to check the placement of gastric feeding is not in practice. why is this gap existing in nursing practice?
3.Preceptors Answer:
An abdominal radiograph is considered the gold standard for determining the position of a nasogastric tube.
And pH testing is the first-line method for NGT placement confirmation .
In the method of checking gastric feeding tube placement by injecting air.
A stethoscope is placed over the epigastrium to listen for a whoosh sound as 10–30 mL of air is insufflated through the NGT. Although auscultation lacks evidence, its advantage is that NGT aspirates are not required. Therefore, it is still used at the bedside, in the absence of an aspirate.
As a preceptor i would communicate this information to my colleagues in volved in research and also to the research department. I may emphasize to get more involved in various research to add body of knowledge and replace with an evidence based practice.