Nasoenteral tube: factors associated with delay between indication and use in emergency services

Abstract

Objective: to know the time between indication and use of a nasoenteral tube (NET) and factors associated with delays. Method: A prospective cohort study that followed adults in a Brazilian emergency department, since the indication of the use of a NET, evaluating clinical variables and the work process. The Generalized Estimated Equations model was adopted to identify factors associated with the delays in each stage of the process. Results: the time between indication and use of NET was 573 (IQR: 360-1,093) minutes, in 150 insertions of NET. Insertions in patients who previously did not use it; delays in the medical, nutrition, and nursing care routine; use of mechanical ventilation; noradrenaline; and fasting were factors for longer time before the use of the tube. Conclusion: the time between indication and use of NET was high, exceeding 10 hours in half of the cases. Factors related to the clinical condition of the patient and to the care management would contribute to delays. Descriptors: Nursing Care; Emergency Medical Services; Gastrointestinal Intubation; Treatment Time; Patient Safety. RESUMO Objetivo: conhecer o tempo entre indicação e uso da sonda nasoenteral (SNE) e fatores associados a atrasos. Método: coorte prospectiva que acompanhou adultos de uma Emergência brasileira, desde a indicação ao uso da SNE, avaliando-se variáveis clínicas e do processo de trabalho. Adotou-se o modelo de Equações de Estimações Generalizadas para identifi car fatores associados a atrasos em cada etapa do processo. Resultados: o tempo entre indicação e uso da SNE foi 573 (IQR: 360-1093) minutos, em 150 inserções de SNE. Inserções em pacientes que anteriormente não a utilizavam, retardos na rotina assistencial médica, da nutrição e enfermagem, uso de ventilação mecânica, noradrenalina e jejum foram fatores para maior tempo até o uso da sonda. Conclusão: o tempo entre indicação e uso de SNE foi elevado, excedendo 10 horas em metade dos casos. Fatores relacionados às condições clínicas do paciente e à gestão da assistência contribuiriam para atrasos. Descritores: Cuidados de Enfermagem; Serviços Médicos de Emergência; Intubação Gastrointestinal; Tempo para o Tratamento; Segurança do Paciente. RESUMENObjetivo: conocer el tiempo entre indicación y uso de sonda nasogástrica (SNG) y factores asociados a demoras. Método: cohorte prospectivo que observó adultos en Servicio de Urgencia brasileño, desde indicación hasta uso de la SNG, evaluándose variables clínicas del proceso de trabajo. Se adoptó modelo de Ecuaciones de Estimación Generalizada para identifi car factores asociados a demoras en cada etapa del proceso. Resultados: el tiempo entre indicación y uso de SNG fue 573 (IQR=360α1093) minutos, en 150 inserciones de SNG. Las inserciones en pacientes que no la utilizaban previamente, demoras en rutina de atención médica, Rev Bras Enferm [Internet]. 2017 mar-apr;70(2):326-34. 327Nasoenteral tube: factors associated with delay between indication and use in emergency services

Factors associated with length of stay and death in tube‐fed patients: A cross‐sectional multicentre study

“…Most of the tube-fed patients were male (52.6%), older adults (mean age of 64 years), at high risk of death (43.3%), with neoplasms (18.3%), diseases of the circulatory system (15.3%) and diseases of the nervous system (10.6%). Similar findings were identified in previous studies conducted with tube-fed patients (Anziliero et al, 2017;Cervo et al, 2014;Ueno et al, 2018).…”

Infection factors related to nursing procedures in Intensive Care Units: a scoping review

“…The practice of such procedures is due to the fact that some of patients in intensive care have nutritional depletion or inability to swallow due to orotracheal tube (OTT) or tracheal tube (TCT) use so that performing NGT and/or NET serves to meet nutritional needs, perform gastric drainage, collect material for examination and administer medications (21)(22) .…”

Aferição do volume residual gástrico: retrato da prática clínica de enfermeiros

“…The most present ENT devices in the study were the Dobbhoff catheter, which is generally employed in the post-pyloric position and is indicated for patients with risk of aspiration, gastroparesis and gastric emptying delay (7) , and the Levine catheter which is recommended for gastric allocation, and allows greater tolerance to a variety of formulas and a larger volume of infused diet, which may lead to an increased risk of aspiration; on the other hand, we can highlight the better cost-effectiveness of this catheter when compared to gastrostomies or jejunostomies (10) .…”