1 JOSE RIZAL UNIVERSITY College of Nursing and Health Sciences Performance Checklist Administering Enteral Feeding via Nasogastric Tube Name of Student: Caryl Jia C. Pamintuan Year/Section/Group No.: BSN 202 Date: 4/17/2023 Grade: __________ Rate the student’s performance by checking the appropriate box using the following criteria: 5- Excellent (Carries out procedure efficiently, systematically and independently/ Personality trait is observed at all times) 4- Very Satisfactory (Carries out procedure efficiently and systematically, requires minimal guidance and supervision/ Personality trait is observed most of the time) 3- Satisfactory (Carries out procedure efficiently and systematically, requires moderate guidance and supervision/ Personality trait is observed sometimes) 2- Fair (Carries out procedure with close guidance and supervision/ Personality trait is seldom observed) 1- Poor (Carries out procedure inefficiently and unsystematically/ Personality trait is never observed) Rationale A. KNOWLEDGE 1. Check physician’s order for type, amount and time of feedings. 2. Wash your hands 3. Assemble equipment. a. Prescribed feeding solution b. 10-20 ml for infant and 5-10 ml for neonate) c. Glass with calibration d. 10-20 ml. water e. Small towel f. Stethoscope B. SKILLS 4. Identify the patient. 5. 6. Bring the equipment to the bedside and explain the procedure to the client. Inspect and palpates patients’ abdomen for distention. 7. Place the patient in high fowlers’ position 8. 9. 10. Spread the small towel across the clients’ chest Attach the syringe at the tip of the NGT. Check placement of the nasogastric tube using the two techniques. a. Aspiration of gastric contents to stomach through syringe using gravity. b. Auscultation – inject 1-5 ml (for infant) and 1-2ml (for neonate) of air while listening with stethoscope positioned at the epigastric area, listened for a whooshing or gurgling sound. 11. Initiate intermittent feeding, pinch proximal end of the feeding tube. To ensure that we are feeding the patient with right amount type and time. To avoid transmission of possible disease or infection. To prepare for the procedure that will be done. To verify if the we are going to do the procedure to the right patient and prevent medical error To be easily access during the procedure. To determine if the patient have remaining formula to the stomach. To prevent aspirations into the upper respiratory tract. To prevent spillage or avoid mess. To prepare for the feeding procedure. To ensure that the feeding will enter the stomach and also to prevent aspiration. To prevent air installation. 2 12. Fill the syringe with formula and keep the bottom of the syringe no higher than 6 inches above the child's stomach. 13. 14. Release tubing and allow formula to flow in by gravity. After administering the prescribed amount of formula, flush tubing with at least 5-20 ml of water (depending on the viscosity of the feed / medication). After feeding is completed, cover end of the feeding tube with plug or clamp. Burp the child and have child's head raised for about 30 minutes after the feeding is done. 15. 16. 17. Rinse equipment with warm water and dry 18. Record / document the procedure and include: a. Type and amount of feeding given b. Time it was given c. Amount of additional water given d. Patients’ tolerance of procedure 19. Monitor breath sounds, bowel sounds, gastric distention, diarrhea, constipation, intake and output, daily weight and serum chemistry results. To prevent aspiration because placing it higher than 6 inches will make the flow of the feeding faster. To begin the feeding. To remove formula and prevent obstruction. To prevent the air from entering the tube. To release the air that the infant swallow from feeding. To clean and sanitize the equipment used. To mark the procedure done and avoid medical error. To monitor the client’s tolerance and to assess nutritional and fluid balance status. TOTAL Total score / Total no of items x 60 + 40 = _____ Total Grade _________ Clinical Instructor’s Comments / Suggestions: ______________________________________________________________________________________________ ____________________________________________________________. Students’ Comments / Suggestions: ______________________________________________________________________________________________ _____________________________________________________________. Caryl Jia C. Pamintuan ________________________________ Student’s name & signature _________________________ C.I.’s name & signature