How Safe Are Your Enteral Feeding Practices?

Only available as part of a package

Due to prematurity and critical illness, over 90% of infants admitted to neonatal intensive care units (NICU) will require placement of orogastric/nasogastric feeding tubes (FTs) and will continue to require FTs for weeks to months. Both FT insertion and placement verification in the NICU is often performed using non-evidence based methods and confusion exists regarding the evidence behind both methods of insertion and verification. Use of non-evidenced based methods increases the risk of malpositioning which is known to cause serious and potentially life-threatening complications. Furthermore, the length of time FTs remain in place may increase the number of potentially pathogenic bacteria present in the FT lumen, potentially increasing the risk of adverse health outcomes. Yet protocols regarding FT dwell time are often not evidence based. These clinical dilemmas not only affect the everyday work life of clinical nurses but the outcomes of using non-evidence-based practices can affect infants and their families for years to come. This session will discuss these clinical dilemmas and their significance in the context of what we know, what we do not know, and what we need to know. In addition, concepts of de-implementation science and changing practice will be presented.

Learning Outcomes:
Articulate evidence-based and non- evidence-based feeding tube verification methods.
Articulate the evidence related to the nose-ear- midumbilicus (NEMU) feeding tube measurement technique versus other measurement methods.
Explain the evidence related to the frequency of routine feeding tube replacement.
Identify how to implement feeding tube best practices in the NICU.

CE Credit Information:

Participants can earn 1 CE credit for viewing the presentation and completing the evaluation.

The National Association of Neonatal Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Kim Cooley, DNP, APRN, NNP-BC, CCNS, C-ONQS

Clinical Nurse Specialist

Emory University Hospital Midtown

Dr. Kim Cooley is a Clinical Nurse Specialist (CNS) at Emory University Hospital Midtown in Atlanta, Georgia. She has practiced as neonatal nurse for 33 years, functioning in multiple clinical leadership roles throughout her career. Dr. Cooley is a board certified advanced practice registered nurse who provides care for well newborn infants and families as a Neonatal Nurse Practitioner and designs, implements, and measures safe, cost effective, evidence-based care strategies as the Clinical Nurse Specialist of Level III Regional Neonatal Intensive Care Unit. She is also certified in quality and patient safety and provides clinical leadership integrating new knowledge and innovation within the neonatal patient population. Dr. Cooley is a reviewer for the Advances in Neonatal Care journal, a member of the CNS neonatal item review committee for the American Association of Critical Care Nurses and served as the National Association of Neonatal Nurses (NANN) Advanced Practice Special Interest Group Facilitator for two terms. She is a published author and contributing author for the NANN Policies, Procedures, and Competencies for Neonatal Nursing Care. Her Doctor of Nursing Practice degree was acquired from the University of Alabama Huntsville with a focus related to neonatal enteral access device confirmation.

Leslie A. Parker, PhD, APRN

Professor

University of Florida

Dr. Leslie Parker is a Professor in the College of Nursing and an adjunct Professor in the College of Medicine. She has had an active practice as a nurse practitioner in the neonatal intensive care unit for the last 30 years. Dr. Parker's research is funded by the National Institutes of Health, industry, and the Gerber Foundation and focuses on (1) optimal delivery of nutrition including optimal feeding time dwell time to reduce feeding tube contamination and risk and benefits of routine gastric residual evaluation as well as (2) increasing infant consumption of their own mother's by improving lactation success in their mothers. Dr. Parker has developed nutritional strategies that health care providers have integrated into their daily practice thus improving short and long-term health outcomes of infants in the neonatal intensive care unit.

Isha A. Alibey, DNP, APRN, ACCNS-N, RNC-NIC

Neonatal Clinical Nurse Specialist

Grady Memorial Hospital, Emory University Nell Hodgson's School of Nursing

Dr. Isha Alibey is a Certified Neonatal Clinical Nurse Specialist specializing in the Neonatal Intensive Care Unit, postpartum and labor & delivery units. With about 14 years of experience in a prestigious Level IV N/IICU, Isha has excelled as a staff nurse, preceptor, and resource nurse, alongside 2 years as a travel nurse. Isha is an active member of esteemed national neonatal organizations, including the National Association of Neonatal Nurses (NANN), the American Academy of Neonatal Nurses (ANN), and the National Association of Clinical Nurse Specialists (NACNS) where she contributed to the Diversity, Equity, and Inclusion Committee. Beyond her clinical roles, Isha imparts her knowledge as a maternity clinical instructor at Emory University’s School of Nursing. Isha is a member of the CNS neonatal item review for the American Association of Critical Care Nurses (AACN). lsha volunteers in Muhimbili National Hospital, Muhimbili, Tanzania through the Emory School of Medicine. Isha’s academic achievements include a Doctor of Nursing Practice (DNP) from Rush University (2020) and a Bachelor of Science (BSc) from Rutgers University (2006).