HomeGrown Solutions is open for submissions. Submissions are reviewed in 4 time periods: January 15th, April 15th, July 15th, and October 15th. Submissions received after each of these dates will be reviewed in the next timeframe.

Teaching NG Tube Care using Nursing Anne

  Submitted by: Christine Repsha on January 10, 2018
  HomeGrown Solution Number: 290
Identification of the Problem
The implementation of high-fidelity manikins to academic nursing labs has increased our ability to teach skills outside of the acute care setting. However, even our highest-fidelity manikin does not allow for teaching medication administration via gastric tube. This is a common practice across the continuum of care for nurses to administer medications via NG, PEG, and J tubes in acute, sub-acute, long-term, and home settings. Furthermore, with the intravenous fluid shortage gastric tubes are being increasingly used for fluid resuscitation and medication administration.
Unique Idea
This particular solution used a Laerdal Nursing Anne manikin but could be modified for use on a variety of moderate fidelity manikins. The salem sump tube was inserted through the nose down into the thoracic cavity of the manikin. The chest was removed and the end of the NG tube inserted into an empty enema bag. This allows the students to incorporate most aspects of medication, nutrition, and fluid administration via gastric tube. By using a manikin compared to a task trainer, the use of the NG tube can be incorporated into a more complex simulation scenario to enhance the students' critical thinking skills.
Objectives
1. Understand the importance of teaching assessment and use of nasogastric tubes in the simulation setting. 2. Understand how to insert and use a nasogastric tube in a moderate fidelity manikin. 3. Identify simulation scenarios where use of nasogastric tube may be incorporated to enhance student learning.
Supplies/Ingredients
1. Nursing Anne manikin
2. Salem sump tube
3. Fishing line or other small string
4. Large volume enema bag
5. Clear surgical tape
6. Scissors
Steps to Creating the Solution
1. Insert salem sump/NG tube in manikin's nose and pull out through mouth. You do not need to use lubricant.
2. Thread string through bottom two holes of salem sump/NG tube.
3. In Laerdal Nursing Anne, the esophagus is located under the tongue. Lift the tongue and insert tube with strings down into hole.
4. Remove manikin chest cavity exposing lungs and stomach. Unscrew the stomach (flesh colored bag).
5. Pull the strings and tube through the esophagus out.
6. Cut tubing off large volume enema bag leaving about 1 inch of tubing above bag.
7. Remove the string and insert the salem sump/NG tube all the way into the enema bag. Secure with tape.
8. Replace the manikin's chest wall and secure NG tube to nares with tape as would be done on a patient.
9. You can now administer fluids, medications, and simulated nutrition to your "patient". Tip: flush thorough with air first to prime the setup.
10. Clean out after ever lab session to prevent build up of mold and clogging.