Critical Tubes

Abstract

<p>This presentation is part of my fulfillment in the graduate program as a Clinical Nurse leader, enacting change within the healthcare system. Within medicine there are many different types of tubes used for many different situations. Two that are routinely used are endo-tracheal (En) and enteral tubes (naso-gastric, nasoduodenal, or naso-jejunal). In infants these tubes can become a life saving measure, and if removed errantly, can have potentially devastating effects. In these instances, the term IIcritical tube" can be used to help delineate these tubes from those less important. The identification and care for these tubes has become increasingly more complicated due to the misuse of the present guideline. Some reasons for this are misuse of the terminology, such as surgeons IIdeciaring" tubes as critical when in fact they do not meet the guideline or may not actually cause harm if removed. Many factors can contribute to the inadvertent early removal of these tubes including; procedures, distraction, lack of sedation, and inadequate staffing. Extensive revision of the current guideline will improve the identification of critical tubes and therefore more consistent care for these babies. This guideline will be revised through the collaborative effort of nursing leadership, beside nurses, an outcomes manager and surgeons from general surgery and ENT. During the revision of the guideline, baseline data on current guideline compliance and bedside nurse comfort with the guideline will be established. Once the revised guideline is completed a comprehensive education initiative and monitoring of compliance will be the initial short-term outcomes. The ultimate outcome will be a reduction in the inadvertent removal of critical tubes and the avoidance of unnecessary harm to infants.</p><p>This presentation occurred at the Wright State University Campus-Wide Celebration of Research, Scholarship and Creative Activities on April 8, 2011</p>