OU - Z:

	Peer 1 2
1. Check MD order
2. Identify patient to explain procedure.
3. Gather supplies: appropriate size tube, water soluble jelly, towel/tissues, cath tip (Toomey or Asepto) syringe, tape or tube holder, suction set up if ordered, safety pin, exam gloves, stethoscope, glass of water if patient not NPO
4. Wash hands, don nonsterile gloves
5. Have patient sit upright if able
6. Measure distance to insert from tip of nose to tip of earlobe then to xiphoid process tip; mark area with tape
7. Lubricate tube
8. Insert in nare with tip aiming down and backward
9. If able to drink allow patient to drink water while inserting; otherwise ask patient to swallow as you advance tube to pretaped mark is reached
10. If patient begins gagging or coughing; allow to rest before advancing tube further
11. Tape into position
12. Check for placement by: aspirating gastric contents (use pH paper to check pH >7 more likely in intestine (alkaline) if < 7 likely to be in stomach (acidic) or auscultate over epigastrium with stethoscope while inserting air with syringe-whooshing noise will be heard.
13. Attach to suction if so ordered.
14. Attach loop of tubing to gown with tape and pin. If sump tube, tape pigtail above stomach level.
15. Wash hands
16. Document size, type tube which nare inserted, type/amt gastric return, placement verified, suction if used, pt tolerance

Peer__________________________________________________Date_________________________________

	Peer 1 2
1. Check physician's order.
2. Identify and explain procedure to patient.
3. Gather supplies: cath tip syringe, irrigating solution (0.9% NS), irrigation set, exam gloves
4. Wash hands and don exam gloves
5. Check for placement
6. Draw up prescribed amount irrigant
7. Disconnect from suction; unless sump tub and then may irrigate sump port with it connected to suction
8. Inject irrigant into port (if using sump pigtail, follow with equal amount air)
9. Withdraw or reconnect to suction
10. Wash hands
11. Document type and amt irrigant used, return color, characteristic, pt tolerance

Peer__________________________________________________Date_________________________________