New Opportunities for Verification of Enteral Tube Location Project: Fact Sheet

The American Society for Parenteral and Enteral Nutrition (ASPEN) is excited to announce the launch of the NOVEL Project. As the world leader in clinical nutrition and metabolism, ASPEN launches the NOVEL Project to address an important issue that our members face. Currently, there is no universal approach to verification of enteral tube location in pediatrics and misplacement of these feeding tubes into the lung with inadvertent administration of enteral formula into the lung has resulted in death or serious consequences for the pediatric patient.

Why was this project developed? 

  • There is no current universal approach to verification of enteral tube location in pediatrics.  Some hospitals may do an x-ray but there is a strong effort in pediatrics to avoid radiation exposure. Pediatric patients can remove their nasogastric feeding tubes several times per day which would involve repeated x-rays and loss of hours of feeding.
  • Misplacement of nasogastric feeding tubes into the lung and inadvertent administration of enteral formula into the lung has resulted in death or serious adverse consequences for the child.

The primary goals for this project are to:

  • Work with inventors and engineers to develop non-radiologic methods to accurately determine the location of a nasoenteric feeding tube upon initial placement and subsequent re-verification of placement
  • Collaborate with nurses to determine best practices for determining nasoenteric tube location working with existing technology and accepted procedures such as pH measurements.
  • Promote consistency of practice among individual nurses and pediatric acute care centers.

Who is involved in with NOVEL Project? 

  • American Association of Critical Care Nurses
  • American Association for Medical Instrumentation
  • Biomedical engineers
  • Children’s Healthcare Association Patient Safety Officers
  • Pediatric home care nurses
  •  A parent whose son died after receiving enteral formula in the lung from an incorrectly placed NG tube
  • Neonatologists and neonatal nurses
  • Venture capitalist who specializes in matching clinical needs with inventors and entrepreneurs.
  • Society for Pediatric Nurses

Who is involved from ASPEN? 

  • Debra BenAvram, CAE, Chief Executive Officer
  • Praveen Goday, MBBS, CNSC, Pediatric  Gastroenterology and Nutrition Medical College of Wisconsin, ASPEN Board of Director
  • Beth Lyman, RN, MSN, Pediatric Nutrition Support Nurse, ASPEN Member
  • Linda Muir,MD, Chair of  ASPEN's Pediatric and Pediatric Gastroenterologist Section, ASPEN Member
  • Jane Anne Yaworski, RN,MSN, Pediatric Nutrition Support Nurse, ASPEN Member 

Who are the target populations for NOVEL Project? 

  • NICU patients
  • Pediatric inpatients
  • Pediatric home patients

What has been done so far? 

  • Developed a position paper on the current status of feeding tube placement verification techniques used in pediatrics.
  • Completed a research proposal for a point prevalence study done on day one to determine how many nasogastric or transpyloric feeding tubes are used in pediatric hospitals.
  • Created a desired features document addressing specific needs of each of the target populations.
  • Work with the FDA to bring awareness to the NOVEL Project.
  • Recruit Biomedical Engineering Colleges to collaborate on this project. Confirmation from the following schools: Massachusetts Institute of Technology (MIT), Stanford University, University of Pennsylvania (UPENN), and University of Cincinnati.

How can people get involved? 

  • Contact Beth Lyman or call 816-855-1766 for a copy of the protocol on Prevalence of Nasogastric Tube Use and obtain IRB permission to participate.
  • Serve as local consultants to biomedical engineering schools who have expressed an interest in working on the NOVEL Project.
  • Analyze your own institution and how nasogastric tube location is determined. 
  • Volunteer to help as needed in work groups.