Inserting guidewires

I’m concerned about the following statement in the article, “Bedside Placement of Small-Bowel Feeding Tubes in the Intensive Care Unit” (February 2003:16–24): “Reinsertion of the guidewire is not recommended by the manufacturer of the feeding tube; however, we had no complications with this technique after placement of 357 tubes.” As a clinical nurse specialist, I’m challenged to utilize evidence-based practice, and to encourage peers to do the same. The above statement disallows that which is evidence based, for staff preference. During my doctoral dissertation about feeding tube placement, at no time did I review any literature that advised reinserting guidewires into feeding tubes indwelling in patients. Because there has been no adverse effect, does not make it prudent practice. Ignoring the literature, and the manufacturer’s recommendation is a potential patient safety and risk management nightmare.