Enteral access device selection.
Enteral tube feedings have once again emerged as the first choice for nutritional support of the patient on the basis of safety, convenience, and economy. In order to provide adequate nutrition, an appropriate route of administration must be identified. Tube selection will depend on an accurate assessment of the patient, including the duration of therapy, history of abdominal procedures, competency of gag reflex, level of debilitation, gastrointestinal function, and discharge plan. Since placement of these tubes may involve several different physicians, a coordinator is necessary. The clinical specialist in nutrition support may be the appropriate health professional to coordinate this care. With an emphasis on shorter hospital stays, more patients may go home with enteral feeding regimens. The clinical specialist will need to be aware of these changes and become more involved in the initial enteral access device decision to insure appropriate selection.