{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:29:28Z","timestamp":1791401368632,"version":"4.3.3"},"reference-count":16,"publisher":"AACN Publishing","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiothoracic surgery patients have an increased risk for aspiration and may require enteral access for nutrition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Local Problem<\/jats:title>\n                  <jats:p>In a cardiothoracic intensive care unit, feeding start times were delayed because of scheduling conflicts with support services. An electromagnetic device (Cortrak 2 Enteral Access System, Avanos Medical) was introduced to allow advanced practice providers (nurse practitioners and physician assistants) to independently establish postpyloric access and reduce dependence on ancillary services.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A quality improvement study was performed. Pre- and postimplementation data included order time, service arrival, tube placement time, tube positioning, and feeding start times for 207 placements. Pre- and postimplementation surveys were conducted to evaluate advanced practice provider satisfaction with enteral tube placement practices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Feeding start time for initial placement decreased by 35.5% (15.6 hours to 10 hours); for subsequent placement, by 55.2% (15.5 hours to 7.0 hours). Assistance by support services decreased by 80.4% (before implementation, 100 of 100 placements [100%]; after implementation, 21 of 107 placements [19.6%]; P &amp;lt; .001; \u03d5 = 0.815). Overall, advanced practice provider satisfaction increased. Most participants said that using the electromagnetic device was faster, nutrition was delivered sooner, and implementation was a valuable practice change.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Using an electromagnetic device decreased feeding start times, reduced the need for support services, and increased advanced practice provider satisfaction with small-bowel feeding tube placement practices.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ccn2023847","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:05:37Z","timestamp":1675209937000},"page":"52-58","source":"Crossref","is-referenced-by-count":3,"title":["Using an Electromagnetic Guidance System for Placement of Small-Bowel Feeding Tubes to Reduce Feeding Start Times"],"prefix":"10.4037","volume":"43","author":[{"given":"Teresa","family":"Wood","sequence":"first","affiliation":[{"name":"Teresa Wood is a nurse practitioner at Duke University Hospital, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Sabol","sequence":"additional","affiliation":[{"name":"Valerie Sabol is a clinical professor and Interim Vice Dean at Duke University School of Nursing, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Engel","sequence":"additional","affiliation":[{"name":"Jill Engel is the Service Line Vice President for Heart & Vascular at Duke University Health System, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah H.","family":"Allen","sequence":"additional","affiliation":[{"name":"Deborah H. Allen is a clinical nurse scientist and Director of Nursing Research and EBP at Duke University Health System."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Julie A. Thompson is a consulting associate at Duke University School of Nursing."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey L.","family":"Yap","sequence":"additional","affiliation":[{"name":"Tracey L. Yap is an associate professor at Duke University School of Nursing."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"2","key":"2023020100023402300_b1-0430052","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/0148607115621863","article-title":"Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)","volume":"40","author":"McClave","year":"2016","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"2","key":"2023020100023402300_b2-0430052","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1002\/ncp.10007","article-title":"Enteral nutrition: options for short-term access","volume":"33","author":"Pash","year":"2018","journal-title":"Nutr Clin 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database","volume":"26","author":"Bourgault","year":"2017","journal-title":"Am J Crit Care"},{"issue":"6","key":"2023020100023402300_b9-0430052","doi-asserted-by":"publisher","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":"2","key":"2023020100023402300_b10-0430052","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1002\/ncp.10062","article-title":"Improved safety and efficacy of small-bore feeding tube confirmation using an electromagnetic placement device","volume":"33","author":"Powers","year":"2018","journal-title":"Nutr Clin Pract"},{"issue":"3","key":"2023020100023402300_b11-0430052","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/s00455-015-9607-4","article-title":"Electromagnetic sensor-guided enteral access systems: a literature 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Class 1 Device Recall Cortrak 2 Enteral Access System (EAS). Accessed September 4, 2022. https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfres\/res.cfm?id=193098"}],"container-title":["Critical Care Nurse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/43\/1\/52\/147127\/52.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/43\/1\/52\/147127\/52.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:05:44Z","timestamp":1675209944000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article\/43\/1\/52\/31965\/Using-an-Electromagnetic-Guidance-System-for"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ccn2023847","relation":{},"ISSN":["0279-5442","1940-8250"],"issn-type":[{"value":"0279-5442","type":"print"},{"value":"1940-8250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}