Module 2302: Nursing Care – Decision Making

Insertion of a Nasogastric (NG) Tube – Student Copy

Student’s Name:
(Please Print)

Student’s Matriculation
Number:
Examiner’s Name:
(Please Print)

Candidate Information

Mrs Alexa Todd has recently been admitted to your ward area with difficulty in swallowing.
You have been asked by your practice supervisor to insert a nasogastric tube.

You are expected to:

 Perform inserting a nasogastric tube into the mannequin.

 Answer 5 questions related to this station.

Time for OSCE: 20 Minutes

Students will be asked to describe the steps of this clinical skill and provide
rationale where appropriate.

Scoring Key:

2 = Achieved / Competent A
1 = Partially Achieved / Competent (meets minimum standard) PA
0 = Not achieved / R = Refer NA

Please circle as appropriate.

Please note: Automatic fail point 21

A refer grade will be applied for any unsafe or unprofessional practice, for example,
incorrect uniform. Any refer will be discussed by the team and verified.

1
Criteria A PA NA
1. Adheres to hand hygiene principles throughout the OSCE 2 1 0
station: Demonstrates hand hygiene with soap and water
at the start of the assessment and then tells assessor
when you would repeat hand hygiene principles
throughout the rest of the assessment either by washing
with soap and water or using an alcohol-based hand
sanitiser.
2. Introduce self to the patient (name and role) and reason for being 2 1 0
there.
3. Check patient’s identification with name band (name, DOB and 2 1 0
CHI number) and asks the patient their preferred name.
4. Explains the rationale to the patient / need for a NG tube and 2 1 0
explain the stages of the procedure.
5. Obtains informed consent / any questions. 2 1 0
6. Tells the assessor: ‘I would perform hand hygiene’. 2 1 0
7. Collects the correct equipment for procedure. 2 1 0
8. Checks expiry dates and correct size of NG tube. 2 1 0
9. Tells the assessor: ‘I would perform hand hygiene’. 2 1 0
10. Assists the patient into correct position for the procedure. 2 1 0
11. Asks the patient which nostril they would prefer to be used and 2 1 0
checks the nostril for patency. Ensures patient can swallow
effectively.
12. Identifies a signal with the patient / carer which signifies they 2 1 0
want you to stop or pause the procedure.
13. Tells the assessor: ‘I would perform hand hygiene’ and dons 2 1 0
correct PPE.
14. Checks the guidewire (if present) to make sure that it moves 2 1 0
freely within the tube, and it is firmly engaged in the tube.
15. Measures the length of tube correctly (NEX) & marks it to identify 2 1 0
the correct distance for insertion.
16. Prepares the nasogastric tube for insertion i.e. wets the end of 2 1 0
the tube with water (according to manufacturer’s guidance and
local policy).
17. Inserts the tube into the chosen nostril and advances straight 2 1 0
backwards along the floor of the nose to the nasopharynx (8–10
cm approx.) reassuring patient throughout.
18. Checks in the patient’s mouth to ensure the tube isn’t coiling and 2 1 0
as the tube passes, asks the patient to start swallowing and sip
water / suck dummy.
19. Explains what to do if an obstruction is felt. 2 1 0
20. Advances the tube into the correct position so that mark is at 2 1 0
nostril and secures the tube to the patient’s nose and cheek with
tape or according to local policy.
21. Collects aspirate and states correct pH of 5.5 or below. 2 1 0

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Criteria A PA NA
22. Identifies if the tube is safe to use then checks by flushing the NG 2 1 0
tube with 30 mL of water (according to local policy) to remove
any aspirated debris.
23. Explains to assessor how to dispose and clean equipment and 2 1 0
remove and dispose of PPE correctly.
24. Tells the assessor: ‘I would perform hand hygiene’. 2 1 0
25. Lists what would be documented in the patient’s notes. 2 1 0
OSCE Total Score /50

Please answer the 5 following questions:

1. When assessing this patient, which systematic approach did you 2 1 0
use? Explain your rationale.
2. Who else might you involve in the person’s care? Name at least 2 1 0
one health care professional and one other.
3. How would you assess the person’s capacity? 2 1 0
4. Discuss one piece of contemporary research evidence that you 4 321 0
have used to support your decision making within this station.
5. What communication skills would you use if your patient became 5 4321 0
distressed? (Assessor - please circle the score.)
Questions Total Score /15

Final Score /65

Please circle as appropriate. D or above to pass.

A 52-65 B 46-51 C 39-45 D 32-38 E 26-31 F 0-25
80-100% 70-79% 60-69% 50-59% 40-49% <40%

Comments:

Examiner’s signature:

Date & Time:

Room Number: