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Gastrostomy/Jejunostomy Tube Insertion

Gastrostomy/Jejunostomy Tube Insertion 

Purpose: 

To provide the safe replacement of a gastrostomy or jejunostomy tube (Foley catheter type). 

Policy: 

Gastrostomy and/or jejunostomy tubes will be replaced when it is determined that the tube is not patent or has fallen out. 

Gastrostomy and/or jejunostomy tubes will be replaced by the physician or by facility registered nurses who have been properly trained in the following procedure. 

A specific physician’s order is required to replace the tube. 

Equipment: 

  • Gloves 

  • Tube (correct size) 

  • Irrigation set 

  • Dressings, if needed 

  • Syringe and water 

  • Water-soluble lubricant 

  • Tape 

Procedure: 

I. Preparation: 

  •  Test the tube balloon by inserting 10cc’s of sterile water or saline. It should be round and should not leak. Deflate the balloon. 

  •  Lubricate the tip of the new tube. 

  •  Deflate the balloon of the tube to be removed. 

II. Removal of Old Tube: 

  • Gently remove the old tube and discard it. 

III. Insertion of New Tube: 

  • Gently insert the new tube all the way into the stomach. 

  • Fill the balloon with 7-10cc’s of sterile water – NEVER USE AIR. 

  • Check the tube for position by aspirating. If gastric contents are returned, the tube is properly positioned and patent. 

IV. Securing the Tube: 

  • Anchor the tube with tape to prevent dislodgement. 

  • Apply a dressing if needed. 

V. Cleanup: 

  • Dispose of equipment properly. 

Documentation: 

  • Document the procedure on the treatment kardex. 

  • Document the reason for the replacement, size of catheter used, condition of the stoma site, and the resident’s tolerance to the procedure in the Narrative Nurses Notes. 

Compliance and Review: 

  • Ensure compliance with CMS guidelines and the State Operations Manual. 

  • Regularly review and update procedures based on the latest clinical best practices and regulatory standards. 

  • Conduct periodic training for staff on the proper replacement of gastrostomy/jejunostomy tubes and monitoring of residents. 

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