New Opportunities for Verification
of Enteral Tube Location Project
The NOVEL Project was launched to address an important issue—what is the best practice to verify nasogastric (NG) feeding tube location in pediatrics? NG tube misplacement can cause serious harm and/or death to patients. X-rays can be used to verify proper tube placement, but with pediatric patients, NG tubes can be removed several times a day. The use of x-rays to verify every tube placement can overexpose these patients to radiation.
NOVEL Pocket Cards - NEW!
This small laminated reference card summarizes the recommended best practices from the NOVEL Project. It also includes a decision tree on when gastric pH measurement should be used and when X-ray is indicated. These quick reference cards have been designed to
fit into a clinician’s badge holder, pocket, or wallet.
Download a PDF of the card
Download a printer-ready version
U.S. and Canada only: to receive a free laminated printed pocket card, please complete a
contact information form.
Printed pocket cards available while
The NOVEL Project task force has created two audience-specific videos highlighting best practices for inserting and verifying the placement of NG tubes in pediatric patients. Please use these videos to train clinicians and caregivers caring for pediatric patients.
The NOVEL videos are now available in Spanish.
These videos were made possible due to a generous grant from
Publications on NOVEL Project
Pediatric Nasogastric Tube Placement and Verification: Best Practice Recommendations From the NOVEL Project. Nutrition in Clinical Practice. 2018;33:921-927
Use of Nasogastric Feeding Tubes for Children at Home: A Template for Caregiver Education. Nutr Clin Pract. 2017;32 (6): 831–833.
Current Practices in Home Management of Nasogastric Tube Placement in Pediatric Patients: A Survey of Parents and Homecare Providers. Journal of Pediatric Nursing. 2017;33:46–53.
Use of Temporary Enteral Access Devices in Hospitalized Neonatal and Pediatric Patients in the United States. J Parenter Enteral Nutr. 2016;40 (4): 574–580.
Verifying NG tube placement in children. Nursing2015;45(10):8.
A Call to Action: The Development of Enteral Access Safety Teams. Nutr Clin Pract. June 2014; 29(3):264–266.
Nasogastric Tube Placement and Verification in Children: Review of the Current Literature. Copublished in Nutr Clin Pract. and Critical Care Nurse 2014; 29(3):267–276.
|Issue 6, December 2018
Issue 5, January 2018
Issue 4, December 2016
|Issue 3, December 2015
Issue 2, March 2015
Issue 1, November 2014
|ASPEN Novel Project Update, May 12, 2014
NOVEL Project Goes International, May 5, 2014
NOVEL Task Force
Formed in 2012, the NOVEL project task force:
- Works with biomedical engineers and industry to develop non-radiologic method(s) to verify NG tube placement and to allow for re-verification of placement
- Collaborates with specialty nursing organizations to determine best practices for determining NG tube location working with existing technology and accepted procedures such as pH measurements
- Fosters the discovery of new knowledge and science and its application to the field of nutrition support (NS) therapy
- Disseminates knowledge that improves clinical practice pertaining to NG tube placement verification
- Advocates on behalf of the field of NS to improve patient outcomes and clinical practice
- Promotes consistency of practice among individual nurses and pediatric acute care centers
- Beth Lyman, MSN, RN, CNSC Children’s Mercy Kansas City (Project Chair, representing ASPEN)
- Peggi Guenter, PhD, RN, FAAN, FASPEN, ASPEN Staff
- Sharon Irving PhD, CRNP, FCCM, FAAN; University of Pennsylvania School of Nursing (representing AACN)
- Carol Kemper PhD, RN; Children’s Mercy Kansas City (representing Patient Safety Officers)
- Candice Moore, BSN, RN; Cincinnati Children’s Hospital (representing home care)
- LaDonna Northington RN, DNS; University of Mississippi School of Nursing (representing Society of Pediatric Nursing)
- Katie Oleksak, MSN, FNP; Pediatric Gastroenterology, Levine Children’s Specialty Center (representing Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN)
- Gina Rempel MD, FRCPC, FAAP; Children’s Hospital Winnipeg (representing ASPEN and international members)
- Wednesday Sevilla, MD, MPH, CNSC; Children’s Hospital of Pittsburgh, UPMC (representing ASPEN)
- Kerry Wilder, RN, MBA from Texas Scottish Rite Hospital (representing NANN)
- Deahna Visscher; Parent Representative and Safety Advocate Denver, CO
- Volunteer to help with the NOVEL Project. Contact Beth Lyman at
- Analyze your own institution and how nasogastric tube location is determined