Policy Manual sample

MDT Home Health Care Agency, Inc. 82 6) If unable to advance the tube, do not use force. Rotate tube gently, withdraw slightly. Try the other side if efforts for advancement are unsuccessful. 7) If gasping, coughing or choking occur, or if the patient shows the predetermined signs of distress, withdraw the tube slightly. 8) Persistent failure of the tube to advance with swallowing may indicate kinking at the back of the throat. Examine the back of the throat. If a kink is visible, withdraw the tube until it is removed. 9) Check for tube placement using these techniques: • Aspirate gastric secretions using 20 - 60 cc syringe. • Inject 5 - 10 cc of air into the tube while listening with a stethoscope placed 1 ½ inches below the xyphoid process. 10) Adjust tubing. Secure with tape to the patient's skin. Use skin prep, if possible. Prevent visual disturbance. Avoid direct friction of the tube against nasal mucosa. 11) Instruct caregiver on oral hygiene, nostril care, changing tape and s/s to report. 12) Remove gloves. Wash hands. 13) Remove and store equipment. DOCUMENTATION: Document the date, the kind and size of tube, the methods used to test placement, the patient's tolerance of the procedure, all teaching and the patient's or caregiver's response on the Clinical Visit Note. ____________________________________________________