ASPEN 2026 Spotlight: Why Neonatal Tube Verification Still Demands Better Bedside Tools
Don Marcello
What ASPEN 2026 Reinforced for NICU Teams
At ASPEN 2026, one of the clearest messages around neonatal feeding tube safety was that verification practices still need improvement. A session on the current state of the science for nasogastric and orogastric tube placement verification in the neonate reinforced a problem clinicians already know well: these tubes are common, they are frequently reinserted, and misplacement still creates meaningful risk for neonatal patients.
That matters because neonatal feeding tubes are part of routine NICU care. When reinsertion is frequent and verification is inconsistent, the exposure to harm is not theoretical. It is operational, ongoing, and directly tied to bedside workflow.
Too many facilities are still using auscultation, and that needs to stop.
Why Better Bedside Tools Matter
One of the most important implications from the ASPEN discussion is that verification is not just an insertion problem. It is also a monitoring problem. Neonates pull tubes, move, grow, and often require repeated reassessment. Any method used in practice has to support not only initial confirmation, but also practical repeat checking over time.
That is where better bedside tools matter. For hospitals working to reduce reliance on outdated practices while improving bedside repeat verification, the distinction between a purpose-built diagnostic device and a generic strip matters.
RightSpotpH® SmallBore was built for NICU and pediatric environments where clinicians need a bedside pH workflow designed for patient safety, repeat checks, and practical implementation. For teams reviewing protocol, that creates a clear opportunity to evaluate whether their current tools still reflect current evidence and workflow demands.
Key Takeaways from the Session
- pH testing and X-ray were highlighted as best-practice verification methods.
- Marked measurement at the nose is not, by itself, a verification method.
- Neonates often require repeated reinsertions, which makes repeat verification and spot-check capability especially important.
- Bedside workflow matters because delays in verification delay care.
- A purpose-built in vitro diagnostic pH device is not the same as a generic pH strip.
Related Patient Safety Context
A related 2025 pediatric patient safety alert reinforces the same concern. It states that auscultation should be discontinued as a tube verification method and emphasizes risk-based confirmation practices instead. In higher-risk situations, radiographic confirmation remains essential. In patients without high-risk conditions, gastric aspirate pH can play an important role in confirmation.
The same alert also highlights a broader operational issue: verification is not only about initial placement. It is also about reassessment after reinsertion, movement, transport, or changes in patient condition.
What NICU Leaders Should Review Now
- Is auscultation still being used anywhere in the workflow?
- Are bedside teams relying on tube markings or measurement at the nose as if they are confirmation methods?
- Is there a clear process for repeat verification after reinsertion, transport, coughing, vomiting, or patient movement?
- Does the current pH workflow rely on generic strips instead of a purpose-built diagnostic device?
References and Related Reading
- Clinical Evidence
- Frequently Asked Questions
- ENA Gastric Tube Placement Verification Guideline (2015)
- Journal of Neonatology/Perinatology NICU Journal Study (Fall 2015)
- Pediatric PSO Alert: NG Tube Placement Verification (2025)
If your NICU or pediatric unit is reviewing tube verification practices, explore our Clinical Evidence, review our FAQs, or request a demo to discuss how RightSpotpH® fits into bedside verification workflows.
