{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:37:25Z","timestamp":1789580245944,"version":"build-2803163510"},"reference-count":41,"publisher":"AACN Publishing","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Blind insertion of feeding tubes remains unsafe. Electromagnetic placement devices such as the CORTRAK Enteral Access System allow operators to interpret placement of feeding tubes in real time. However, pneumothoraces have been reported and inadequate user expertise is a concern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore factors influencing competency of CORTRAK-assisted feeding tube insertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, observational pilot study was conducted. Data collection included demographics, self-confidence, clinical judgment regarding CORTRAK-assisted feeding tube insertion, and general self-efficacy. CORTRAK-assisted feeding tube insertions were performed with the Anatomical Box and CORMAN task trainers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty nurses who had inserted a mean of 53 CORTRAK feeding tubes participated. Participants inserted a mean of 2 CORTRAK feeding tubes weekly; each had inserted a feeding tube in the past 7 days. All superusers were competent; 1 required remediation for improper receiver unit placement. Mean (SD) scores were 35 (3.68) on a 40-point scale for self-efficacy, 4.6 (0.68) on a 5-point scale for self-reported feeding tube insertion confidence, and 4.85 (0.49) on a 5-point scale for demonstrated confidence. Participants estimated that 8 CORTRAK-assisted insertions were needed before they felt competent as super users. Confidence with the CORTRAK tracing was estimated to require 10 feeding tube insertions. Six participants continued to assess placement by auscultation, suggesting low confidence in their interpretation of the tracing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At least 3 observations should be performed to assess initial competency; the number should be individualized to the operator. Interpretation of the insertion tracing is complex and requires multiple performance opportunities to gain competency and confidence for this high-risk skill.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ajcc2019170","type":"journal-article","created":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T09:15:16Z","timestamp":1546334116000},"page":"30-40","source":"Crossref","is-referenced-by-count":27,"title":["CORTRAK Superuser Competency Assessment and Training Recommendations"],"prefix":"10.4037","volume":"28","author":[{"given":"Annette M.","family":"Bourgault","sequence":"first","affiliation":[{"name":"Annette M. Bourgault is an assistant professor and Laura Gonzalez is an associate clinical professor and simulation coordinator at University of Central Florida College of Nursing, Orlando, Florida. Bourgault is also a nurse scientist at Orlando Health, Orlando, Florida. Lillian Aguirre is a clinical nurse specialist in trauma and critical care at Orlando Regional Medical Center, Orlando, Florida. Joseph A. Ibrahim is trauma medical director at Orlando Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gonzalez","sequence":"first","affiliation":[{"name":"Annette M. Bourgault is an assistant professor and Laura Gonzalez is an associate clinical professor and simulation coordinator at University of Central Florida College of Nursing, Orlando, Florida. Bourgault is also a nurse scientist at Orlando Health, Orlando, Florida. Lillian Aguirre is a clinical nurse specialist in trauma and critical care at Orlando Regional Medical Center, Orlando, Florida. Joseph A. Ibrahim is trauma medical director at Orlando Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Aguirre","sequence":"first","affiliation":[{"name":"Annette M. Bourgault is an assistant professor and Laura Gonzalez is an associate clinical professor and simulation coordinator at University of Central Florida College of Nursing, Orlando, Florida. Bourgault is also a nurse scientist at Orlando Health, Orlando, Florida. Lillian Aguirre is a clinical nurse specialist in trauma and critical care at Orlando Regional Medical Center, Orlando, Florida. Joseph A. Ibrahim is trauma medical director at Orlando Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Annette M. Bourgault is an assistant professor and Laura Gonzalez is an associate clinical professor and simulation coordinator at University of Central Florida College of Nursing, Orlando, Florida. Bourgault is also a nurse scientist at Orlando Health, Orlando, Florida. Lillian Aguirre is a clinical nurse specialist in trauma and critical care at Orlando Regional Medical Center, Orlando, Florida. Joseph A. Ibrahim is trauma medical director at Orlando Health."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"5","key":"2020032812320571400_b1-0280030","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1177\/0148607106030005440","article-title":"Enhancing patient safety during feeding-tube insertion: a review of more than 2,000 insertions","volume":"30","author":"Sorokin","year":"2006","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"4","key":"2020032812320571400_b2-0280030","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1177\/0115426507022004436","article-title":"Bedside electromagnetic-guided feeding tube placement: an improvement over traditional placement technique?","volume":"22","author":"Gray","year":"2007","journal-title":"Nutr Clin Pract"},{"issue":"5","key":"2020032812320571400_b3-0280030","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/0148607110386047","article-title":"Small bowel feeding tube placement using an electromagnetic tube placement device: accuracy of tip location","volume":"35","author":"Rivera","year":"2011","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"2020032812320571400_b4-0280030","article-title":"CORTRAK Enteral Access Device approval letter K091637","author":"US Food and Drug Administration"},{"issue":"2","key":"2020032812320571400_b5-0280030","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/SLA.0b013e318208f550","article-title":"A team-based protocol and electromagnetic technology eliminate feeding tube placement complications","volume":"253","author":"Koopmann","year":"2011","journal-title":"Ann Surg"},{"issue":"6","key":"2020032812320571400_b6-0280030","doi-asserted-by":"crossref","first-page":"521","DOI":"10.4037\/ajcc2013755","article-title":"Elimination of radiographic confirmation for small-bowel feeding tubes in critical care","volume":"22","author":"Powers","year":"2013","journal-title":"Am J Crit Care"},{"issue":"7","key":"2020032812320571400_b7-0280030","doi-asserted-by":"crossref","first-page":"354","DOI":"10.12968\/bjon.2014.23.7.352","article-title":"Confirming nasogastric tube position with electromagnetic tracking versus pH or X-ray and tube radio-opacity","volume":"23","author":"Taylor","year":"2014","journal-title":"Br J Nurs"},{"issue":"2","key":"2020032812320571400_b8-0280030","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/PCC.0b013e31819a3668","article-title":"Successful placement of postpyloric enteral tubes using electromagnetic guidance in critically ill children","volume":"10","author":"October","year":"2009","journal-title":"Pediatr Crit Care Med"},{"issue":"15","key":"2020032812320571400_b9-0280030","doi-asserted-by":"crossref","first-page":"876","DOI":"10.12968\/bjon.2017.26.15.876","article-title":"Cortrak tube placement part 2: guidance to avoid misplacement is inadequate","volume":"26","author":"Taylor","year":"2017","journal-title":"Br J Nurs"},{"issue":"9","key":"2020032812320571400_b10-0280030","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1007\/s00268-015-3077-6","article-title":"Naso-enteric tube placement: a review of methods to confirm tip location, global applicability and requirements","volume":"39","author":"Milsom","year":"2015","journal-title":"World J Surg"},{"key":"2020032812320571400_b11-0280030","unstructured":"Feeding tube placement systems: letter to health care providers. 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Nurs"},{"issue":"6","key":"2020032812320571400_b27-0280030","doi-asserted-by":"crossref","first-page":"525","DOI":"10.4037\/ajcc2015493","article-title":"Verifying placement of small-bore feeding tubes: electromagnetic device images versus abdominal radiographs","volume":"24","author":"Bryant","year":"2015","journal-title":"Am J Crit Care"},{"issue":"1","key":"2020032812320571400_b28-0280030","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/jhm.2122","article-title":"Analysis of an electromagnetic tube placement device versus a self-advancing nasal jejunal device for postpyloric feeding tube placement","volume":"9","author":"Boyer","year":"2014","journal-title":"J Hosp Med"},{"issue":"2","key":"2020032812320571400_b29-0280030","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/NND.0000000000000041","article-title":"An organizational competency validation strategy for registered nurses","volume":"30","author":"Levine","year":"2014","journal-title":"J Nurses 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