Nasogastric Tube Care Plan (for all types of NG tube)
Reason for Nasogastric Tube Affix patient label
Type of tube Date inserted
pH on insertion Limiting mark
Referral to dietitian sign date
Referral to speech and language therapist sign date
Date
Action E L N
Hand hygiene
Wash hands and wear non-sterile gloves prior to manipulating tube
Patient hygiene and comfort
Inspect mouth and provide regular mouth care
Clean nostrils daily and change adhesive tape if soiled
Ensure tube is well secured in place on face/cheek/nose
Rotate external position of the tube and check for pressure damage
Tube position
Check limiting mark on tubes is in correct position and record this in cm here every shift. Refer to
policy if evidence of malposition
Check position of NG tube prior to administration of feed, drugs, at least once during each
continuous feeding episode and after violent coughing or obvious tube movement
Check gastric aspirate 4 hourly to confirm stomach position, and indicate which confirmation
method below is used
a. pH less than or equal to 4
b. pH less than or equal to 4 after patient drank half-diluted orange squash
c. pH less than 5 and aspirate is “grass green” or more than 10ml
d. pH less than 5 and patient on ranitidine/omeprazole/lansoprazole
Adult nasogastric tube insertion record
Type of NG tube
Manufacturer
Batch no Date inserted
Reason for NG tube insertion
Tube limiting mark
Proposed date for tube replacement
Inserted by
Signature
Verification of nasogastric tube tip placement by either pH paper or X-ray.
X-ray is only required after following the NG tube placement flow chart in
Enteral Nutrition policy
pH result (please state level)..............
Checked by. Name
Signature
Time
Date
X-ray taken: Yes/No (delete as appropriate)
X-ray date
Time
Correct tip position confirmed by a competent practitioner
Decision taken to feed yes/no
Competent practitioner role
Name
Signature
Date
Time