Checkoff – NG Tube Insertion – NASOGASTRIC TUBE INSERTION SKILL VALIDATION
NASOGASTRIC TUBE INSERTION
SKILL VALIDATION
Student Name: _____________________________________ Date: _____________________
Supplies Needed
Salem sump tube, anti-reflux valve, lubricating jelly, paper tape, lopez valve, piston syringe, pH paper, admission kit, disposable straw, tongue depressor
Equipment Needed
Nursing Manikin, pen light
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Points Allowed
1
st
Attempt
2
nd
Attempt
Preparation
Perform I-CHECK: Introduce yourself; Check armband
(two patient identifiers
); Hand hygiene; Explain procedure; Check order; Keep privacy
+1
Assess
the patient prior to procedure
· nasal passages
· gag reflex
· mental status
· determine the appropriate tube size (typically 8-12 Fr for feeds/meds; 16-18 Fr for gastric decompression) Checkoff – NG Tube Insertion – NASOGASTRIC TUBE INSERTION SKILL VALIDATION
+4
Insertion
Preparation
:
· Place the patient in high Fowler’s position & apply drape to patient
· Provide an emesis basin and cup of water with straw
+2
Don clean gloves
+1
Measure the NG tube
from nose to earlobe to xiphoid process (NEX) and mark the length
+1
Apply water-soluble lubricant to the tube tip and gently insert it into the most patent nostril following the natural curve (if resistance occurs, reattempt with more lubrication or use the other nostril)
+1
As the tube reaches the oropharynx, instruct the patient to swallow water and advance the tube with each swallow, monitoring for signs of distress
+1
Check for position in the back of throat
· Secure the NG tube to the patient’s nose
+2
For Salem sump tubes, attach the one-way valve to the blue air vent and a Lopez valve to the other (for other NG tubes, attach a Lopez valve to the main lumen) Checkoff – NG Tube Insertion – NASOGASTRIC TUBE INSERTION
SKILL VALIDATION
+1
Post-Procedure
Verify correct placement
by aspirating gastric contents, checking pH (≤5);
· Verbalize patient would also need to go to x-ray
+2
If ordered, connect the NG tube to low intermittent suction
+1
Remove gloves and perform hand hygiene
+1
Document the procedure, including the date, time, size of the NG tube, insertion depth, placement verification methods, and patient’s tolerance of procedure
No point but required
Total Points (successful/Unsuccessful) 15 out of 18 needed to be successful
Comments
Evaluator Initials or Signature: _____________________________________ Date: _____________________
1
ST
Attempt Pass ____________/Needs Remediation___________________
Evaluator Initials or Signature: _____________________________________ Date: _____________________
2
nd
Attempt Pass ____________/Lab Fail_____________________________
Checkoff – NG Tube Insertion – NASOGASTRIC TUBE INSERTION SKILL VALIDATION
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