ARAB EURO HOME NURSING NASOGASTIC FEEDING AND CARE TO PATIENT` S WITH NASOGASTRIC TUBES I. Purpose: I.

1 To ensure that nurse will gain knowledge regarding the indications and purposes of NGT.
I.2 To ensure safe practice in insertion of NGT upon doctor` s legal order and

patient` s consent. I.3 To ensure safe practice when feeding/ administering medications to patients with NGT.
I.4 To ensure safe and effective nursing care to patients with NGT intact.

II. Policy:
II.1 The following Policy and Procedure shall be adhered to when administering

NGT feedings/ medications to protect the patient and the nurse from exposure to negligence/or malpractice and other adverse occurrences. II.2 The use of standard precautions and the monitoring of the patient` s condition shall be adhered to throughout administering feedings and medications.
II.3 Prior to ordering NGT insertion, feedings and administering medications, the

appropriate consent shall be obtained by the Physician.

II.4 In the event of presence of complications from NGT feedings and medication

administration or misplacement of NGT , the appropriate referral or report must be made to the Physician, Clinical Supervisor and Nurse Team Leader. III. Scope III.1
III.2

III.3 III.4

Physician Registered Nurse/ Home Care Nurse Clinical Supervisor Nurse Team Leader

IV. Responsibilities
IV.1

Physicians: Physician` s shall gain consent to NGT insertion prior to the administration of the prescribed discharge/ home feedings and medications.

IV.2

Registered Nurses: The home care nurse must ensure that the appropriate consent has been obtained prior insertion of NGT, as well as before any NGT feedings/ medication administration. The home care nurse shall use Universal/Standard Precautions when initiating NGT feedings or when inserting NGT. The home care nurse shall ensure the patency and correct placement of the NGT prior feeding. The home care nurse shall ensure that the osterized food is balance and free from any contamination. The home care nurse must ensure that the patient will received the prescribed amount of OF, after checking the patient` s residual stomach content. The home care nurse must demonstrate the proper way of giving NGT feeding. The home care nurse must always monitor patient` s response from NGT feedings, any referrals must be reported promptly to the immediate supervisor, and physician.

V. Definitions/ Abbreviations: NGT: OF: Fr: VI. Procedure: NGT insertion: The registered nurse verifies the physician` s order for feedings via NGT route. The registered nurse verifies the patient` s consent regarding the procedure. Explain the procedure to the client/ relatives. Wash hands. Gather the equipment needed such as; NGT Fr. 16-18 Adult Fr. 10-14- Infant/ Child Stethoscope Sterile Gloves KY Jelly Irrigation Kit Adhesive tape Asepto syringe Position the patient in High Fowlers and place towel over chest. Prepare tape to mark tubing and to secure the tube to the clients` s nose. Naso gastric tube Osterized food French

Put clean gloves and determine the length of the tube to be inserted by measuring tube from the tip of the nose to the tip of the ear to the xiphoid process. Lubricate the tip of the tube at insert to the nostril advancing to the posterior pharynx. Once the tube is in the posterior pharynx have the client head tilt forward while supporting the patient` s back of the head to maintain the position. Ask the client to swallow while advancing the tube. Temporarily tape the tube to the nose and assess for proper placement by two methods; Auscultate with stethoscope over left upper abdominal area while injecting 10-20 ml of air and noting air sound in gastric region; or by Aspirating gastric contents, yellow to green colored fluid. Secure tube by taping to the bridge of the nose and anchoring to the patient` s gown with safety pin. Dispose the used supplies properly using infection control policy. Position patient for comfort. Document the procedure. NGT Feedings: The registered nurse verifies the physician` s order for feedings via NGT route. The registered nurse verifies the patient` s consent regarding the procedure. Explain the procedure to the client/ relatives. Wash hands. Gather equipment needed such as; Clean gloves Stethoscope Measured glass of water Prescribed feeds Asepto syringe Protective material such as towel Place the patient in semi to high fowlers position or a lateral if patient cannot be propped up. Assess for patency. Observe the nature of aspirate for color, volume and presence of blood. Attach funnel / Syringe to the tube and hold it to the side, at the level of the patients forehead. Fill the funnel/ syringe with the prescribed feed and medication (if present), allowing it to flow in by gravity. Do not allow the funnel to become empty. Observe the patient during feed. Conclude feed with water. Disconnect the tube and record the type and amount of feed and water given.