PURPOSE: To describe techniques used in a major teaching hospital that help prevent complications of gastrostomy and jejunostomy tubes and manage complications when they do occur.

OBJECTIVE: WOC/ET Nurses are often consulted about the management of jejunostomy and gastrostomy tubes, and they provide guidance to the healthcare staff on tube stabilization, treatment of peri-tubular skin irritation, and containment of effluent when leakage occurs around the insertion site. We developed and implemented a procedure for routine care to be followed by the nursing staff, while remaining available to assist with questions and complex consultations. The focus on complicated cases by the WOC/ET Nurses led to the development of two new techniques that stabilize the tube while collecting drainage. These procedures have not been previously reported in the literature and will increase the repertoire of treatment options the WOC/ET Nurse can offer.

OUTCOMES: In our facility, tube dislodgment and peri-tubular skin irritation has likely decreased because of the routine use of tube stabilization by the healthcare staff. This has led to WOC/ET Nurse consultations on the more complicated cases. Using novel techniques, we were able to secure the tube, measure volume of the leakage, protect the peri-tubular skin, and enhance patient comfort.

CONCLUSION: Standardizing the management of tubes can improve patient outcomes and help prevent leakage and skin irritation. Tube attachment devices are valuable tools in the care of uncomplicated and complicated feeding tubes. Use of these new options in practice will increase the repertoire of choices for the WOC/ET Nurse when these complex consultations arise.

FINANCIAL ASSISTANCE/DISCLOSURE: The support of Hollister Incorporated for this project is gratefully acknowledged.