Learning Objective #1: Identify sources in the literature that discuss the increased use PEG tubes in infants and children

Learning Objective #2: Identify criteria that physicians and nurses use in determining the type of tube placed for enteral nutrition

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While recruiting hospitalized children for a study of nasogastric/orogastric (NG/OG) tubes, a trend of early placement of percutaneous endoscopic gastrostomy (PEG) tubes was noted. When speaking with nurses, they reported “we do not have many NG tubes. Most kids have G-tubes.” It appears that children are receiving PEG tubes earlier in their clinical course. This information precipitated our looking at whether PEG tubes were being utilized more frequently than other types of enteral tubes in the literature as well as our hospital and why.

Since the inception of the PEG tube in 1980, there have been multiple articles published about PEG tubes, including some focusing on children. Once a review of the pertinent literature was completed, a retrospective chart audit of 50 children having a PEG tube continues. Age, height/length, weight, diagnosis, medical service, use of total parenteral nutrition, the length of time between definitive diagnosis and placement of the PEG tube, and whether the child had an NG/OG tube placed any time prior to PEG tube placement are being documented.

Once the retrospective audit is completed, we plan to conduct qualitative interviews with 10 physicians who order enteral nutrition in their pediatric patients to ascertain what criteria they use to select the tube being placed, 10 nurses working with children with NG/OG/PEG tubes to determine which type of tube they prefer to care for, parents of 10 children who have had both a NG/OG tube and PEG tube to see which tube the parents preferred, and 10 children who have had both tubes to determine their preferences.

Data from the chart review will be reported using descriptive statistics, and data from the interviews will be summarized using content analysis. The results of this study will provide baseline knowledge regarding this apparent changing trend in short-term enteral feeding in children.