Nasogastric Tube Insertion Teaching Plan

Introduction

Leaders that set high achievable goals are leaders who are willing and able to take responsibility for a task through giving appropriate education or experience to nursing students as well as the nursing practitioners. A nasogastric tube is one of the most sensitive equipment that calls for great care on the part of the nursing team; otherwise, misplacement of this tube can lead to short as well as long term consequences to the patient using it. The major causes of misplacement of the tube could result from coughing, respiratory illness, head position, and anatomic abnormality, among others, causes (Best, 2008). However, there are also other unusual causes of displacement such as the case of oropharyngeal suction (Arora, Roffe, & Crome, 2005). The complications that may arise following nursing errors include pneumonia, esophagus puncture, blockage of the tube, irritation, and bleeding, among other complications (Lubin, & Smith, 2006).

A teaching plan of nasogastric tube insertion is therefore paramount due to the logistics involved while inserting the tube, as it serves the purpose of reducing the consequences that result from poor insertion and maintenance of the tube. More so, teaching nasogastric tube insertion creates room for a framework that enables the nursing students to handle the tube effectively at an individual level, and this helps them build up a sense of responsibility. Therefore, proper teaching of nasogastric tubes is of paramount importance since it helps the nursing profession to be in line with the dynamic technological changes taking place in the nursing discipline. The nutrition specialist nurse should offer the teaching plan of nasogastric tube insertion, as he can give an informed review on its effectiveness (Cannaby, Evans, & Freeman, 2002).

Teacher’s Objectives

The characteristic of the learner is of utmost importance while coming up with a teaching objective since learning is characterized by different levels of understanding, hence producing different dimensions of intellect (Patterson & Young, 2007). While teaching the nursing students on a nasogastric tube, the teacher’s objectives will involve engaging the inexperienced nursing students’ team in the nasogastric tube insertion and its maintenance; creating an avenue for the nursing students to effectively obtain patients information before tube insertion. The teacher will also provide the nursing students with proficient skills of collecting feedback from the patients who are already using the nasogastric tube (Chang et al., 2004).

In engaging the learners with patients using the nasogastric tube, the learners should be conversant with information about the IOM and JCAHO policies (Sorokin & Gottlieb 2006), the learners should be able to extract clinical data relative to nasogastric tube insertion from the patients’ records obtained through diagnosis (Marini & Wheeler, 2006). The learners should also be able to relate patients’ diagnoses with timely application of the nasogastric tube to facilitate proper patients care (Yarbro, Goodman, & Frogge, 2005). In obtaining patient knowledge, the nursing students should demonstrate strong observational skills, including PH scale, that endeavor to provide full knowledge of how the patient should be positioned to respond effectively to the nasogastric tube. In the ability to provide feedback on how the patient is performing, the nursing students should be able to identify the reason behind unproductive results of a nasogastric tube (Corless & Foster, 1999).

Teaching Strategies, Choice of Teaching Model and the Rationale for Its Use

The teaching strategy that will most suit the teaching plan for nursing students is a clinical simulation in collaboration with moralistic education since this provides the learners with an opportunity for skills acquisition (McCaughey & Traynor, 2010). Clinical simulation scenarios help the nursing students in understanding how to deal with the problems that emanate from the nasogastric tube. The simulation scenarios are not only meant for skill practice but also help in developing students’ clinical judgment and underlying concepts reinforcement in order to develop a safe evidence-based practice (Bradshaw & Lowenstein, 2007).

The clinical simulation procedure for nasogastric tube insertion is very sensitive. In the class of eight students undergoing the simulation process, the nurse in charge should be a professional to handle the group. Using the traditional model, the nurse should divide the group into two (a group of four each) since he will be able to monitor the group well when it is smaller. The group should understand the key study and develop learning objectives. The nutrition specialist nurse, who is in charge, should have a sheet that contains a number of columns, which are used to test the learning objectives of the students. This model is effective since it analyses each event with its corresponding questions and teachings.

More so, clinical simulation in nursing is found to be imperative since it creates a favorable atmosphere for the students, as they are ascertained that the simulation will not count in their final grading for their semester (Emerson, 2007). As such, a friendly survey questionnaire was provided to each student before tube insertion to assess the students’ knowledge on how the nasogastric tube should be inserted. This teaching strategy was found to be imperative since it facilitated acquiring comprehensive knowledge at an individual level.

Learner Outcomes

To evaluate the performance of the system, the three learning outcomes that will be measured include demonstration ability for tube insertion and maintenance, investigative abilities demonstrated by the nursing students, and ability to collect patients’ feedback while they are using the nasogastric tube (Gopee, 2008). The nursing students should be able to demonstrate how to insert the tube, how cleaning of the tube should be done, how blockage of the tube should be prevented, identify the patients’ conditions that call for intervention by the nutritional specialist nurse. In the investigative abilities of the nursing students, the learning process should create room for cross-comparison between the pre-test and the post-test on matters pertaining to the nasogastric tube to assess the additional information that the learners have added. Finally, the nursing students should be able to demonstrate that they have incorporated their lifestyle with the learning process by receiving and giving patients feedback effectively (Rose & Best, 2005).

Evaluation Strategies

This teaching plan aimed to increase the nursing students’ level of confidence while inserting the nasogastric tube, maintaining it, and addressing the patient using it. In the light of this plan, the evaluation tool used to measure whether the learning has taken place is the Likert scale, where the respondents could specify the extent of their agreement/disagreement with a particular learning objective. More so, this scale helped in assessing the level of confidence of each nursing student at the end of the teaching plan. This played a critical role in the evaluation process since the opinions of students involved in the learning process should not be overlooked (Cannaby, Evans, & Freeman, 2002).

References

Arora, A, Roffe, C., & Crome, P. (2005). An unusual and overlooked complication of nasogastric tube feeding. Age and Ageing, 34(1), 84-85. ProQuest.

Best, C. (2008). Nutrition: A handbook for nurses. Chichester, West Sussex, U.K: Wiley-Blackwell.

Bradshaw, M. J., Lowenstein, A. J. (2007). Innovative teaching strategies in nursing and related health professions. Sudbury, MA: Jones & Bartlett Publishers.

Cannaby, A., Evans, L., & Freeman, A. (2002). Nursing care of patients with nasogastric feeding tubes. British Journal of Nursing, 11(6), 366. ProQuest.

Chang, W., McClave, S., Lee, M., Chao, Y. (2004). Monitoring Bolus Nasogastric Tube Feeding by the Brix Value Determination and Residual Volume Measurement of Gastric contents. Journal of Parenteral and Enteral Nutrition, 28(2), 105. ProQuest.

Corless, I. B., & Foster, Z. (1999). The hospice heritage: Celebrating our future. New York: Haworth Press.

Emerson, R. J. (2007). Nursing education in the clinical setting. St. Louis, Mo: Mosby Elsevier.

Gopee, N. (2008). Mentoring and supervision in healthcare. Los Angeles: SAGE Publications.

Lubin, M. F., & Smith, R. B. (2006). Medical management of the surgical patient: A textbook of perioperative medicine. Cambridge: Cambridge University Press.

Marini, J. J., & Wheeler, A. P. (2006). Critical care medicine: The essentials. Philadelphia: Lippincott Williams & Wilkins.

McCaughey, C. S., & Traynor, M. K. (January 01, 2010). The role of simulation in nurse education. Nurse Education Today, 30(8), 827-32.

Patterson, B. & Young, L. (2007). Teaching nursing: developing a student-centered learning environment. Philadelphia: Lippincott Williams & Wilkins.

Rose, M., & Best, D. (2005). Transforming practice through clinical education, professional supervision, and mentoring. London: Elsevier Churchill Livingstone.

Sorokin, R., & Gottlieb, J. (2006). Enhancing Patient Safety During Feeding-Tube Insertion: A Review of More Than 2000 Insertions. Journal of Parenteral and Enteral Nutrition, 30 (5), 440. ProQuest.

Yarbro, C. H., Goodman, M., & Frogge, M. H. (2005). Cancer nursing: Principles and practice. Sudbury, Mass: Jones and Bartlett Publishers.

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