JOSE RIZAL UNIVERSITY

College of Nursing and Health Sciences

Performance Checklist
Administering Enteral Feeding via Nasogastric Tube

Name of Student: _Nika Eunice Mojar___ Date: _03/29/22__________

Year/Section/Group No.: _2nd 202N_/Grp 2__ 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)

Procedures Rationale
A. KNOWLEDGE
1 Check physician’s order for type, amount Check appropriate orders relevant to patient safety.
. and time of feedings.
2 Wash your hands To prevent transmission of microorganism present in
. your hand.
3 Assemble equipment. To save time and effort
. 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. Patient identification mistakes can lead to errors in
. procedures being perform on a wrong patient
5 Bring the equipment to the bedside and For easy access to all the materials.
. explain the procedure to the client.
6 Inspect and palpates patients’ abdomen for Document assessment findings and determine
. distention. appropriateness of NG tube insertion related to reason
for insertion and patient’s physical assessment.
7 Place the patient in high fowlers’ position This allows the NG tube to pass more easily through the
. nasopharynx and into the stomach.
8 Spread the small towel across the clients’ Nasal and oral secretions may be evident during the
. chest procedure.
9 Attach the syringe at the tip of the NGT.
.
1 Check placement of the nasogastric tube Before putting some liquid you need to check the NGT if
0 using the two techniques. it is in a proper place.
.
a. Aspiration of gastric contents to
stomach through syringe using
gravity.
b. Auscultation – inject 1-5 ml (for B. Sound generated by air blown through the tube is
infant) and 1-2ml (for neonate) of used to determine tube placement in the gastrointestinal
air while listening with stethoscope tract.
positioned at the epigastric area,
listened for a whooshing or
gurgling sound.
1 Initiate intermittent feeding, pinch This keeps fluid from coming back out.
1 proximal end of the feeding tube.
.
1 Fill the syringe with formula and keep the The higher of the syringe controls how quickly the
2 bottom of the syringe no higher than 6 formula is given.
.
inches above the child's stomach.
1 Release tubing and allow formula to flow To start the feeding
3 in by gravity.
.
1 After administering the prescribed amount To prevent the tube from becoming clogged.
4 of formula, flush tubing with at least 5-20
.
ml of water (depending on the viscosity of
the feed / medication).
1 After feeding is completed, cover end of This allows air to get into his stomach and can cause
5 the feeding tube with plug or clamp. discomfort.
.
1 Burp the child and have child's head raised Burping allows your baby to remove some of that
6 for about 30 minutes after the feeding is gassiness to relieve the pain.
.
done.
1 Rinse equipment with warm water and dry It will be ready for the next time you will use it again.
7
.
1 Record / document the procedure and For references.
8 include:
.
a. Type and amount of feeding given
b. Time it was given
c. Amount of additional water given
d. Patients’ tolerance of procedure
1 Monitor breath sounds, bowel sounds, Timely and accurate documentation promotes patient
9 gastric distention, diarrhea, constipation, safety.
.
intake and output, daily weight and serum
chemistry results.
TOTAL
Total score / Total no of items x 60 + 40 = _____

Total Grade _________

Clinical Instructor’s Comments / Suggestions:

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____________________________________________________.

Students’ Comments / Suggestions:

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_____________________________________________________.

________________________________ _________________________
Student’s name & signature C.I.’s name & signature