COLLEGE OF HEALTH SCIENCES

Related Learning Experience

Procedure Checklist

Insertion of Nasogastric Tube

Name______________________________ Date ____________________

Group ___________________ Score __________

Grading Criteria
SCORE DESCRIPTION
1 The student performed the skill completely and correctly
0 The student performed the skill incompletely and incorrectly or did not perform the
item at all

Performance Skill Done Not Remarks

Done
1. Verify the medical order for insertion of an NG tube.
2. Gather all necessary equipment
 Large- or small-bore tube (nonlatex preferred)
 Nonallergenic adhesive tape, 2.5 cm (1 in.) wide
 Clean gloves, surgical scissor
 Water-soluble lubricant
 Facial tissues
 Glass of water and drinking straw
 20- to 50-mL catheter-tip syringe
 Basin
 pH test strip or meter
 Stethoscope

3. Perform hand hygiene and put on PPE, if indicated.

4. Introduce self to the patient
5. Identify the patient.
6. Explain the procedure to the patient and provide the rationale as
to why the tube is needed.
7. Assess patency of nares. Have patient close each nostril
alternately and breathe.
8. Stand on same side of bed as naris chosen for insertion and assist
patient to high-Fowler’s position unless contraindicated. Place
pillow behind head and shoulders
9. Determine length of tube to be inserted and mark with tape.
10. Put on gloves. Lubricate tip of tube at least 2–4 inches with
water-soluble lubricant. Apply topical anesthetic to nostril and
oropharynx, as appropriate.
11. Insert the tube, with its natural curve downward, into the
selected nostril. Ask the client to hyperextend the neck, and gently
 advance the tube toward the nasopharynx

12. When pharynx is reached, instruct patient to touch chin to

chest. Encourage patient to sip water through a straw or swallow if
no fluids are permitted. Advance tube in downward and backward
direction when patient swallows until desired length has been
passed.

13.. Discontinue procedure and remove tube if there are signs of

distress, such as gasping, coughing, cyanosis, and inability to speak
or hum.
14. Ascertain correct placement of the tube. Leave stylet in place
until correct position is verified by x-ray.

15. If an x-ray is not feasible. Attach syringe to end of tube and

aspirate a small amount of stomach contents and measure the pH.
16. Secure the tube by taping it to the bridge of the client’s nose
after confirming correct placement.
17. Measure length of exposed tube. Reinforce marking on tube at
nostril with indelible ink
18. Fasten end of nasogastric tube to patient’s gown using piece of
tape
19. Remove and discard gloves. Perform hand hygiene
20. Document the type of tube inserted, date and time of tube
insertion, the means by which correct placement was determined,
and the client’s tolerance of the procedure
Total Score (20)
References:

Berman, A., Kozier, B., Erb, G. L., Snyder, S., Levett-Jones, T., Dwyer, T., Hales, M., Harvey, N.,
Langtree, T., Moxham, L., Parker, B., Reid-Searl, K., & Stanley, D. (2018). Kozier and Erb's
fundamentals of nursing: Concepts, process and Practice. Pearson Australia.

Lynn, P. B., & Taylor, C. (2011). Taylor's clinical nursing skills: A nursing process approach. Wolters
Kluwer/Lippincott Williams & Wilkins Health.

Potter, P. A., Hall, A., Stockert, P. A., & Perry, A. G. (2013). Fundamentals of Nursing. Elsevier.

Evaluated by: Conforme:

__________________________________ __________________________________
Signature over Printed Name of Instructor Signature over Printed Name of Student