Hand Hygiene: Wash hands following CDC guidelines to ensure patient safety.
Introduce Self: Clearly introduce yourself to the patient.
Patient Identification: Use two patient identifiers to confirm the patient's identity.
Allergy Check: Verify the patient's allergy status.
Materials Needed
Lopez valve
Cup of water and straw
Suction tubing
Specimen cup
Stethoscope
Water-soluble lubricant
Absorbent pad or towel
Penlight
Tongue blade
pH strips
Tape
NG strip
Irrigation tray
Piston syringe and needle
Gastric tube
Procedure Steps
Initial Assessment
GI Assessment: Assess the necessity for nasogastric tube placement.
Patient Positioning: Place the patient in a high Fowler’s position, covering the chest with a towel or absorbent pad.
Explain Procedure: Explain the procedure to the patient and develop a hand signal for communication.
Facial/Nasal Assessment: Use a penlight to assess for any issues in facial or nasal passages that may contraindicate the procedure.
Equipment and Suction
Suction Verification: If suction is ordered, verify the suction source and connect the suction tube to the source of negative pressure, adhering to physician's orders.
Measuring the Tube
Tube Measurement: Measure from the tip of the Nair to the earlobe, then to the xiphoid process of the sternum. Mark the tube with tape or a marker.
Insertion
Lubrication: Lubricate the first four inches of the tube with water-soluble lubricant.
Insertion Technique:
Ask the patient to slightly flex their neck backward.
Insert the tube into the Nair, gently pulling back if gagging occurs until it ceases.
Have the patient tilt their forehead forward, offering water with a straw or encouraging dry swallowing to assist insertion.
Advance the tube as the patient swallows until the marked point reaches the Nair.
Be cautious of respiratory distress and pull back immediately if any signs occur.
Securing the Tube
Secure Tube: Do not let go of the tube until it is securely in place.
Verification and Connection
Placement Verification: Aspirate stomach content to test pH and verify correct placement.
Connection: Connect the distal end of the tube to the suction, draining bag, or adapter as per evidence-based guidelines.
Post-Procedure
Cleanup: Dispose of soiled supplies properly.
Ensure Safety: Ensure the environment is safe, returning the bed to its lowest height with brakes locked, side rails up, and call light within reach.
Final Hand Hygiene: Wash hands again following CDC guidelines.