Measurement and verification of gastric tube positioning in newborns: comparison between nurses practice and evidence

Abstract

Introduction: Accurate measurement and verification of gastric tube placement in newborns is essential to ensure patient safety and prevent complications such as aspiration, perforation, and nutritional failures. Despite its importance, studies reveal discrepancies between clinical practice and evidence-based recommendations, highlighting the need to assess the role of nursing professionals in this context. Objective: To describe the practice of neonatal nurses regarding methods of measuring and verifying gastric tube placement in newborns, comparing them with the literature. Methods: Exploratory, cross-sectional, and quantitative study, using a questionnaire applied to neonatal unit nurses. Results: Forty-seven nurses participated, 95.7% women (n=45), with a mean age of 40.3 years; 100% (n=47) were specialized in neonatology. The most used technique for nasogastric tubes (NGT) was NEX (nose–ear–xiphoid appendix), used by 59.6% (n=28), also predominant for orogastric tubes (40.4%, n=19). Although all participants considered their knowledge good or excellent, only 4.3% (n=2) simultaneously employed the recommended strategies. Epigastric auscultation was the most cited verification method (85.1%, n=40), followed by chest-abdominal X-ray (66.0%, n=31) and gastric residuals (40.4%, n=19). None used the pH test. No significant association was found between adequate practices and professional experience or training. Conclusion: A misalignment with evidence was identified, mainly due to the predominant use of the NEX technique. Methods such as NEMU (nose–ear–midpoint between xiphoid appendix and umbilicus) and pH measurement were scarcely adopted, reinforcing the need for training, protocols, and adherence to safe practices.