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Use what you have for Medication Administration/Enteral Feeding by Gastrostomy tube

  Submitted by: Hope Meyers on July 13, 2015
  HomeGrown Solution Number: 258
Identification of the Problem
Very common in the pediatric in-hospital setting is the use of gastronomy tubes for medication administration and enteral feeding. It is important that students have as much hands-on practice with skills that are unique to certain populations as possible. We recently initiated g-tube medication administration practice in our BSN pediatric practicum skills day, which is where this solution was created. A lot of times manikins are designed for specific skills which can limit their uses, and that is where we found ourselves. We were without a pediatric manikin that could be used for g-tube medication administration. I’d research different simulator options, but could not justify purchasing a simulator that would be used only twice a year & would cost from $500-$800.
Unique Idea
The goals/objectives were to: 1. Utilize equipment we already had to meet the goals set forth by the faculty for their practicum 2. Make the solution as realistic and practical as possible Utilizing equipment/supplies you already have reduces the expenses needed to meet the goals of your lab experiences as well as providing a solution that is readily available. This solution can be used for pediatrics or adult manikins as well.
Objectives
Supplies/Ingredients
1. Any manikin with corresponding abdominal plate with interchangeable stoma sites
2. Gastronomy tube (Used: MIC-KEY low profile gastrostomy feeding tube)
3. Primary IV tubing (that allows fluid to flow back into the bag)
4. Empty IV fluid bag (your preference in size, just consider how much will fluid be administered & how often the bag might need to be emptied)
5. Hemostats
Steps to Creating the Solution
1. Use a manikin (no internal electronic parts) that has an abdominal plate with interchangeable stoma sites
2. Remove one of the blank abdominal plugs from the abdominal plate.
3. Connect your empty IV fluid bag to your primary IV tubing.
4. Take the other non-connected end of the primary IV tubing and feed it into the opening of the urinary reservoir black connector.
5. Use the hemostat to grab the tubing and pull it out through the colostomy hole – a little over an inch of the primary IV tubing should be in the g-tube.
6. Push the gastrostomy tube over the end of the primary IV tubing
7. Store drainage bag inside abdominal cavity or under manikin (I prefer in the abdominal cavity for a more realistic experience).
8. Make sure to un-clamp the primary IV tubing's roller-clamp before administering fluids through g-tube.
9. * Note: Periodically check connection between the g-tube and Primary IV tubing to make sure it has not been pulled apart and liquid is now leaking inside your manikin.