Challenges of de-implementing feeding tube auscultation: A qualitative study

Aim This qualitative study explored de-implementation of feeding tube auscultation practice in adult patients by critical care nurses. Background Despite years of evidence suggesting inaccuracy and harm, auscultation (air bolus method) continues to be used by the majority of critical care nurses to verify small-bore feeding tube placement in adults. Design This descriptive qualitative study used thematic analysis with telephone interview data. Methods Fourteen critical care nurses from four stratified groups within the United States (by hospital type and auscultation practice) participated in telephone interviews. Results Two major themes of individual influence and organizational leadership emerged from the data. Categories identified key components required for auscultation de-implementation. Conclusions Nurses feel obligated to follow hospital policies and expressed less accountability for their own practice. Organizational leadership involvement is recommended to facilitate de-implementation of this tradition-based, low-value practice and mitigate harm events.