The most common product to secure a gastric tube is tape or a similar, more expensive adhesive product. The tape is inexpensive, readily available, and reasonably effective if applied properly. The downside is the overall security of a tube held with tape depends on the type of tape used, the technique in applying it, and more importantly, how often it gets changed.
Focusing on intubated patients, we interviewed the dietitian of a 21-bed Intensive Care Unit in Canada’s second-largest acute care facility. “We have seen the rate of small-bore feeding tube loss drop from a rate of 36% in ’92 to approximately 10% presently. This decline is mainly attributed to changing the tape more regularly and securing the tube better using a protective skin barrier swab. Since many variables affect when tape needs to be changed, it is important to regularly monitor the adhesive integrity. This is a simple, yet easily forgotten task.”
When a duodenal or jejunal feeding tube loss is prevented many dollars are saved, considering the time and skill needed to replace them in addition to the X-ray needed to verify proper placement. Some tubes have to be placed under endoscopy or fluoroscopy making a tube loss that much more expensive.
Although sump-type gastric tubes are less costly and easier to replace, one should also consider the discomfort and trauma of re-insertion.
US cost analysis: Tape vs TubeSafe
The estimated cost to secure a gastric tube with Tape including skin Prep. is approximately $0.17 US ($0.07 for tape and about $1.10 for labor). Comparatively, with intubated patients, securing a gastric tube with TubeSafe costs roughly $1.63 or less ($1.97 for the TubeSafe and only $0.31 for labor). The difference is a saving of $0.48 with tape. However, for the tape to remain effective, it is suggested that the tape be changed on nasally placed tubes every 3-5days, which makes the TubeSafe more cost-effective for any patients intubated longer. If the gastric tube needs repositioning, the costs of the tape job doubles, making the TubeSafe a cheaper alternative.