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.