This topic has haunted me for years, both as a practitioner and as a teacher of nursing. Yet, after all of the work done by Metheny and colleagues, as the authors of this article note, I was losing hope we could ever change the way nurses confirm placement of enteral tubes.

I did an informal survey of hospitals in the greater Cincinnati area several years ago and found that many had adopted nursing skills textbooks as their official "procedure manual." Even though those books clearly stated that auscultation is unreliable and that pH testing is much more accurate for determining placement of feeding tubes, nurses continued to auscultate, and charting forms supported that practice.

Thanks for this well-written and widely accessible article. I look forward to the day when nurses embrace evidence-based practice.

Ann Denney, MSN, RN

Crestview Hills, KY