In a study reported in this issue, O’Meara and colleagues1 provide evidence that underfeeding via the enteral route is a serious problem in critically ill patients. Although other researchers2 –5 have reported similar findings, these researchers provide an opportunity to consider where changes could have been made to alleviate the problem.

In their observational study, O’Meara and colleagues found that it took a mean (SD) of 18 (26.9) hours for bedside nurses to insert feeding tubes into the small bowel. This is an area of practice that can be improved. Following a reasonably short training period, a group of critical care nurses were able to insert 339 small-bowel feeding tubes in a time-efficient manner (mean, 22 min; range, 5–180 min).6 Therefore, in intensive care settings where postpyloric feedings are commonly used, it behooves each unit to train several nurses in this technique to prevent lengthy delays...

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