Feeding Tube Attachment Device Versus Conventional Fixation and Its Impact on Accidental Exit of Enteral Feeding Tubes

Patients will be randomly assigned to the intervention group consisting of the use of the feeding tube attachment device (FTAD) or the control group that will use the conventional method of attachment with micropore adhesive tape and tape . The data will be compared by Student's t test or Mann-Whitney and Pearson's chi-square, according to their distribution. The project was approved by the Ethics and Research Committee of the Hospital de Clínicas de Porto Alegre. Daily will be accessed through the diet map, available in the hospital application, patients who are in use enteral nutrition. These data will be tabulated in the screening worksheet, those who meet the eligibility criteria will be invited to participate in the study and requested the reading and signing of the informed consent by the patient or guardian. The study investigator will inform the allocation group to the guest patient.By means of a structured questionnaire, socio demographic and clinical information will be collected: age, gender, reason for current hospitalization, comorbidities and information related to enteral probe (type of probe, place and date of insertion, number of medications in use via enteral probe, type and the date of the last fixation change).

Traditional fixation with micropore and plaster is routinely performed by the nursing staff every 24 hours or whenever necessary. The procedure will be performed as described in the study protocol (item 1.1).

The feeding tube attachment device (FTAD) contains a layer of hydrocolloid that will attach to the skin and a clamping clamp around the probe. The placement of the catheter fixation device will be performed by the research nurses, these will be previously trained by the manufacturer of the material. The fixing procedure is described in item 1.2.

Patients included will be evaluated daily for study outcomes up to the suspension of enteral nutrition prescription, hospital discharge, death or up to 35 days of follow-up. Patients starting enteral probe use on Saturday and Sunday can be up to 48 hours with the traditional method of fixation and later will be randomized to the intervention or control group.

1.1 Control Group After inclusion in the study, initial evaluation and information to the patient, the attending nurse will follow up on the exchange of the traditional enteral probe fixation device that occurs according to the standard operating protocol in the institution that recommends micropore fixation according to the "tie" technique and exchange Every 24 hours and whenever it is loose or with presence of dirt.

1.2 Intervention Group

After inclusion in the study and the initial evaluation, the patient will be informed of the intervention to be submitted. The care nurse will place the catheter fixation device, which according to the manufacturer, should follow the following instructions:

• Wash the patient's nose with soap and water that does not release residue;
• Rinse vigorously and dry thoroughly.
• Remove the paper that isolates the adhesive barrier (step 1);
• Position the device so that the fastener is approximately 1 cm below the tip of the nose. Apply the barrier to the patient's nose, pressing the barrier surface gently against the skin for 60 seconds (step 2);
• Fasten the feeding probe, closing the clamp around it, and firmly tighten the arms to fully engage the serrated teeth (step 3);
• To remove, raise clamp. Place the tip of one finger over the ledge on the opposite arm and turn the arm to open (step 4).

The exchange of the device should be every 7 days, in the presence of dirt or if material deterioration occurs.