Many new enteral nutrition (EN) formulas have been created over the past several decades with a variety of intended uses. Although each is intended to promote improved outcomes, research is often unclear and, in many cases, conflicting. It is important to note that EN products are considered medical foods by the U.S. Food and Drug Administration and therefore do not have to complete premarket review or approval and are not regulated to the same extent as pharmaceuticals. While standard EN formulas are designed to meet the basic macro- and micronutrient requirements of individuals who cannot meet nutrition needs orally, specialty EN products have been developed to exhibit pharmacologic properties, such as immune-enhancing formulas containing arginine, glutamine, nucleotides, and ω-3 fatty acids. With the vast number of products available, rising costs of healthcare, and the drive toward evidence-based practice, it is imperative that clinicians carefully consider research regarding use of specialty formulas, paying close attention to the quality, patient population, clinical end points, and cost to patient and/or facility.

Registered dietitian nutritionists (RDNs), like other healthcare professionals, are often searching for ways to improve their skills and advance their practice. One way RDNs have expanded their skills is by learning to place small bowel feeding tubes (SBFTs). However, it is also important that staffing RDNs to place SBFTs makes sense for their institution and their patient population. Although it is unknown how many RDNs place SBFTs, feeding tube placements by RDNs have been in practice for almost 2 decades, and it is within the RDN scope of practice. This article is a review of the literature, including indications for SBFT, possible benefits of RDNs placing SBFTs, development and maintenance of an RDN-led SBFT program, and assessment of clinical and institutional outcomes for this procedure. (Nutr Clin Pract. 2019;34:858-868)

Nasogastric/nasoenteric (NG/NE) feeding tube placements are associated with adverse events and, without proper training, can lead to devastating and significant patient harm related to misplacement. Safe feeding tube placement practices and verification are critical. There are many procedures and techniques for placement and verification; this paper provides an overview and update of techniques to guide practitioners in making clinical decisions. Regardless of placement technique and verification practices employed, it is essential that training and competency are maintained and documented for all clinicians placing NG/NE feeding tubes. This paper has been approved by the American Society for Parenteral and Enteral Nutrition (ASPEN) Board of Directors.

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