Policy Manual sample

MDT Home Health Care Agency, Inc. 54 GASTRIC TUBE STABILIZATION AND DRESSING PURPOSE: Gastric tubes are stabilized to prevent erosion of the skin around the tube and to prevent tube migration or removal. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: • Bag for old dressing • Antiseptic cleanser as ordered by physician or soap and water, wash cloth, towel • Gloves • 4 x4 gauze GENERAL CONSIDERATIONS: 1. Gastrostomy stoma site area care for new, infected or draining wounds will require site care as ordered by the physician. Healed stomas can be cleansed with soap and water and may not need a dressing. 2. One of the problems noted with gastric tube feedings is tube migration. This may cause Pyloric or intestinal obstruction, which is prevented by proper anchoring. 3. Excoriation of the stoma edges may occur when lateral traction or taping of the gastric tube is done. Alternate the direction of traction or ease the tension of the traction should this occur. PATIENT AND FAMILY EDUCATION: 1. Education of the patient/caregiver should include the purpose of the stabilization technique and the care of the stoma site. 2. Inform the patient/caregiver of complications and s/s to report to MDT Home Health Care Agency, Inc. nursing staff or the patient’s primary care physician. PROCEDURE: 1. Wash hands. Gather equipment. 2. Remove old dressing and discard. 3. Cleanse around tube as ordered. 4. Place a 4x4 gauze pad around gastric tube. Tab the tape ends if 4x4 is taped in place. Tape may not be needed on a well-healed site. 5. If necessary, tape tube down approximately 4 inches from stoma site. 6. Store equipment. 7. Remove gloves, wash hands. DOCUMENTATION: Document the site assessment, the procedure and any education to the patient/caregiver on the Clinical Visit Note. ____________________________________________________