Running Head: Nasogastric Tube Teaching and Evaluation

Nasogastric Tube Teaching and Evaluation

Melissa B

Nasogastric Tube Teaching and Evaluation

A forty-seven year old African-American male presented in the Emergency Department last
week complaining of nausea, generalized abdominal pain and vomiting bright red blood. AA,
(patient reference) has an extensive medical history to include poorly controlled insulindependent diabetes and uncontrolled hypertension directly resulting in renal failure requiring
dialysis. The Emergency Doctor ordered a nasogastric tube or NG tube to be inserted to assess
the gastrointestinal bleeding.
AA had never experienced hematemesis or a tube placed into his nose that went into his
stomach. After an informal conversation with AA about his background and reviewed medical
history, AA admits that personal healthcare had not been a priority for several years. AA also
explained that his lack of understanding the details of a nasogastric tube increased his anxiety
which directly heighted his fear of medical procedures. AA's learning according to the author,
Bastable (2008), " The prime motivator to learn in adulthood is to be able to apply knowledge
and skills for the solution of immediate problems." The abdominal pain and nausea motivated
AA to ask questions about nasogastric tubes and the relief provided by this intervention. The
purpose of this teaching session was to educate the patient about the nasogastric tube insertion.
Teaching would immediately be useful in reducing AA's stress and the physical discomfort the
patient was experiencing.
The fifteen minute teaching session included a short video demonstrating the NG insertion
step-by-step and access to supplies used in the procedure. These teaching aids were incorporated
in helping my patient to accomplish the following behavioral objectives:
1. After the completion of the fifteen minute teaching session the patient will identify the
equipment used for the nasogastric tube placement.

Nasogastric Tube Teaching and Evaluation

2. After watching a short video demonstrating the application of the nasogastric tube, patient
will admit to any fears associated with the procedure.
3. Following a demonstration of the head position required for nasogastric tube insertion, patient
will practice correct head position.
The first objective teaching strategy utilized the cognitive domain and the method of one on
one instruction with the use of teaching aids. Chapter 8 in Nurse as Learner and Teacher, Blais
and Hayes (2011) suggest, "Teaching aids can foster learning and help focus a learner's
attention," and continues on that "learning is more effective when learners are assisted to
discover the content for themselves." I presented the NG tube supplies on a bedside tray next to
AA along with a printed list of same. The seven pieces of equipment were named and located on
the list provided which took approximately six minutes. To evaluate the effectiveness of the
teaching I verbally quizzed the patient by holding up the individual supplies and listening to the
response.
The second objective teaching strategy involved using a multimedia presentation from the
Nursing-Resource.com website demonstrating nasogastric tube insertion, review of supplies and
requirements of the patient. The video is realistic by filming a patient experiencing the same
procedure and in a similar setting. The affective domain or "feeling" domain is accessed by
allowing AA to admit or discuss fears associated with the impending procedure. Bastable (2008)
believes, "Learner feelings or emotions cannot help but be aroused to some extent when exposed
to new and different educational experiences." This discussion lasted about five minutes and I
felt it allowed for an open dialogue between myself and AA which was the main purpose. This

Nasogastric Tube Teaching and Evaluation

domain is difficult to evaluate and Bastable (2008) explains "affective behaviors are not
usually overt and clearly observable."
Lastly the psychomotor strategy or skill based teaching was implemented in the nasogastric
tube teaching session. This was a straightforward demonstration and return demonstration of the
head forward, chin-tuck position required to ease the passage of the NG tube into the esophagus.
In addition to the demonstration, Medscape.com provided an image depicting the required head
position. AA practiced this position on my cue for about four minutes. I maintained the
simplicity of this motor response and was careful not to integrate other domains in the patients
teaching. Psychomotor was evaluated on the observed return demonstration of hyperextension
of the head and chin.
The teaching session went well based on the evaluation of the behavioral objectives and the
goals perceived and met. It was rewarding to experience that using the domains as guides held
the patient's attention and perhaps invoked thoughtfulness into one's health. In the future, I
would pick a teaching subject with more web based patient teaching. I had a difficult time
finding web based teaching from other than a procedural perspective.

Nasogastric Tube Teaching and Evaluation

References
Bastable, Susan B. (2008). Nurse as Educator: Principles of Teaching and Learning for
Nursing Practice. 3rd ed. Sudbury, Massachusetts: Jones and Bartlett
Blais, K., Hayes, J.S. (2011). Professional Nursing Practice: Concepts and Perspectives. 6th ed.
Boston: Pearson
Nursing-Resource.com (2010, Feb. 15). NGT Insertion [Website]. Retrieved from
http://nursing-resource.com/ngt-insertion/#contents
Shlamovitz, G. (2014). Medscape [Website]. Retrieved from
http://emedicine.medscape.com/article/80925-overview#a15