Nasojejunal tube insertion: a survey of practices across the UK

Objective Postpyloric feeding via nasojejunal tube (NJT) is often indicated in patients with gastric pathology such as gastroparesis, altered anatomy or poor gastric feed tolerance. Given that national guidance on NJT use is outdated, this study aimed to assess current variation in NJT insertion techniques and ongoing care across the UK. Methods An online survey consisting of 12 questions was disseminated via the social media platform ‘X’, with responses collected between May 2023 and January 2024. Results A total of 92 responses were received, representing 54 National Health Service (NHS) hospitals across England, Scotland, Wales and Northern Ireland. Only 13 hospitals (24.0%) reported access to all NJT insertion methods—bedside, radiological and endoscopic—while the majority (41 hospitals; 75.9%) lacked access to bedside techniques. The primary barriers to implementing bedside NJT insertion were identified as the need for training (36%), cost (25%) and safety concerns (15%). Regarding postinsertion confirmation, 36 hospitals (66.7%) did not require X-ray confirmation following endoscopic NJT placement. In contrast, among hospitals offering bedside insertion, 8 (61.5%) required X-ray confirmation. On the wards, 49 hospitals (90.7%) routinely checked centimetre markings at the nose to ensure tube positioning before use. Conclusion The limited availability of bedside NJT insertion may place additional demands on endoscopy and radiology services. Additionally, wide variation exists in postinsertion protocols, including the use of abdominal X-rays. Updated national guidelines are needed to standardise NJT practices across the UK.