MODULE OF SKILL LABORATORY PRACTICE

BLOCK : GASTRO-INTESTINAL SYSTEM

TOPIC : PROCEDURE FOR INSERTING NASOENTERIC TUBE

I. GENERAL OBJECTIVE
After finishing skill practice of procedure for inserting Nasoenteric Tube, the
student will be able to perform procedure for inserting Nasoenteric Tube
correctly.

II. SPECIFIC OBJECTIVES

At the end of skill practice, the student will be able to perform procedure for
inserting Nasoenteric Tube correctly

III. SYLLABUS DESCRIPTION

3.1 Sub Module Objective
After finishing skill practice of aseptic techniques procedure, student will
be able to perform for inserting Nasoenteric Tube correctly.
3.2 Expected Competencies
Perform procedure for inserting Nasoenteric Tube correctly

3.3 Topics
Procedure for inserting Nasoenteric Tube

3.4 Methods
a. Presentation
b. Demonstration
c. Coaching
d. Self practices

3.5 Laboratory Facilities

1. Skills Laboratory
2. Clinical Instructors
3. Student Learning Guide
4. Instructor guide
5. References
6. Equipment
7. Standardized patient

3.6 Evaluation
a. Skill demonstration
b. Point nodal evaluation
c. OSCE

IV. EQUIPMENT ARRANGEMENT

All equipment required for this topic include :
1. Multimedia equipment
2. Examination couch
3. Table
 4. Chairs
5. Stethoscope
6. Pelvic models

V. SUPPORTING EQUIPMENT AND FACILITIES

1. Water tap with running water
2. Wash basin
3. Nasoenteric tube

VI. LEARNING GUIDE OF INSERTING NASOENTERIC TUBE

No. Procedure Comment

1 2 3 4
Preparation
1. Check all the equipment required
and have a good condition :
Nasoenteric Tube
Stylet
Hand gloves
Lubricant
Aquadest
Stetoscop
Syringe 10 cc
Steril Drape
Lamp/ penlight
Plester
Scissor
Clamp
2. Explain the procedure and its
goals to the patient.
3. Wash your hands with antiseptic
soap
4. Dry and warm your hands with
tissues
Implementation
1. Provide privacy
2. Explain procedure and its purpose
3. Place patient in sitting position with
neck flexed slightly and head of
bed elevated to 45 degrees (semi
fowler)

4. Inspect nares and determine

optimal patency by having the
patient breathe through one nostril
while the other is occluded
temporarily.
Clean the nares if dirty using steril
gauze
 5. Wash hand and using steryl hands
gloves
6. Place the drape to the patient’s
chest
7. Estimate distance for placement
into stomach by measuring the
length from the tip of the nose to
the earlobe and then from the
earlobe to the xiphoid process.
9. Observe marking on shaft of tube
for guidance or with clamp
10. Lubricate stylet about 10 cm and
insert into feeding tube
10. Lubricate chosen nostril with
water-soluble lubricant.
11. Lubricate the end of the tube or
activate the self lubricant with
water and pass it posteriorly
12. If The patient is alert and
cooperative, ask him or her to
swallow water to facilitate tube
passage
13. Once the tube is beyond the
nasopharynx, allow the patient to
rest
14. Have the patient flex the neck and
swallow while the tube is advanced
15. If the patient begins to cough,
withdraw the tube into the naso
pharinx, and then reattempt
passage.
16. Confirm the passage into stomach
by aspiration of gastric contents
first with 2 technique :
1. Looking gastric content, end of
NGT drawn to aqua
2. Using spuit given air follow
NGT and hearing the air buble
through stetoscop on epigastric
position
and then abdominal x-ray film.****
17. Secure tube to bridge of nose or
upper lip with nonallergic tape or
tube attachment device.
18. Observe the gastric content (is it
blood, mucus,etc)
**** Note Global rating

VII. CRITERIA OF PERSONAL PERFORMANCE EVALUATION

 PERFORMANCE ACHIEVEMENT COMMENT
SCALE
1. If students are doing the task that only fill
less than 35% of whole items for each step LOW
precisely
2. If student are doing the task that only fill MILD
35% - 60% from whole items for each step
precisely
3. If student are doing the task that only fill MODERATE
60% - 78% from whole items for each step
precisely
4. If student are doing the task that fill at least EXCELLENT
80% from whole items for each step
precisely