Age-specific methods have the potential to predict accurately the distances to the body of the stomach in 98.8% of children from 0.5 to 100 months of age and in 96.5% of children over 100 months of age. Where age-specific prediction methods cannot be used, the next best choice is the nose or mouth to ear-mid-xiphoid-umbilicus span.

Approximately 1 million enteral tubes are placed through the nose or mouth in adults and children in the United States annually. Previous studies found gastric tube placement errors to be common. A primary issue in ensuring safe and effective gastric feeding by tube is achieving optimal tube position on insertion. The purpose of this study is to use 24 variables to develop a clinical prediction rule for gastric tube insertion distance in adults, using the internal-nares-to-distal-lower esophageal-sphincter distance. A three-variable model using gender, weight, and nose-umbilicus-flat was selected. This new model, validated using nonparametric bootstrap cross-validation, correctly predicted gastric tube insertion distance 85.3% of the time. This new model is compared to two other methods, one evidence based and one commonly used in practice, and was found to be superior. Two nomograms, one for each gender, are drawn to make this new model easier to use.

issues and purpose. A primary issue in ensuring safe and effective enteral feeding by tube is achieving and maintaining correct tube position. This study was conducted to determine the prevalence of tube placement errors, risk factors associated with these errors, and accuracy of commonly used bedside placement‐screening methods. design and methods. In this descriptive study, 39 hospitalized children having one or more types of enteral tubes were studied prospectively. Tube placement was assessed across time, using three common placement‐screening methods compared to radiographs. results. Tube placement error occurred in 43.5% of tubes at least once during the observation period. Children who were comatose or semicomatose, were inactive, had swallowing problems, or had Argyle tubes were more likely to have tube placement errors. practice implications. Findings suggest that radiographs to document tube placement may be needed, at least on initial enteral tube insertion.

By examining the relationship of scientific and ethical knowledge to practice, it can be shown that much of the knowledge required for practice is the knowledge of science and ethics. This brings the notion of the need for a practice theory in nursing into serious question since unique knowledge beyond that of science and ethics must be shown to be required in practice.