G-TUBE TEACH at Levine's

PREPARATION

1. Familiarize yourself with G-tube basics, care, and troubleshooting.

2. Review Infinity Pump and Farrell bag setup and usage.

3. Links to review:

   • Gastrostomy Care: G-tube

   • Infinity Attaching Feeding Set to Mini G-Tube Button

   • Enteralite by Moog

ARRIVAL to LEVINES

1. Parking and Entrance:

   • Park in the BLUE parking deck.

   • Get ticket and take inside to be validated. If you run into an issue with validation, you will be reimbursed.

2. Enter Levine Children’s Hospital Main Entrance. Security Check-in:

   • Proceed to the main desk.

   • Ensure your Helms Home Care badge is visible.

   • Inform security you are visiting and provide the room number, if you have it.

   • Obtain a visitor badge, you will need this for access to patient elevators and patient floors.

3. Navigating to the Patient’s Room:

   • Ask for directions to the patient’s room

ON ARRIVAL to the UNIT

1. Meet the Nurse:

   • Upon arrival at the unit, locate the patient’s nurse.

   • Explain that you are there for a bedside G-tube teaching session.

   • Ask if the Case Manager is available and check in with them if possible.

2. Equipment in the Room:

   • Confirm all necessary supplies are available in the room. There should be 3 boxes sent by pharmacy.

   • Infinity Pump – box includes the pump, a charger and a pole attachment

   • Feeding Bags and feed solution – these are not to be used while patient is in the hospital

   • IV Pole

   • Folder with pharmacy information and number – make patient aware that this is where pharmacy information is and where all the education materials are located

NEED to KNOW

1. Feeding sets/tubing are good for 24 hours

2. Feeding/formula is good for 12 hours. Store any opened containers in the fridge and take out about 20 – 30 minutes prior to feed to come to room temperature.

3. If no flushing orders, use the standard Atrium protocol. May use tap water at home.
   

   Atrium Flushing Protocol – before and after feeds:

   Ages 0 – 11 months: Flush with 3 ml room temp tap water

   Ages 12 months and older: Flush with 3 – 5 ml room temp tap water
   

4. If patient has a Farrell bag hanging and no Farrell bag on your orders, check with the nurse as sometimes they will use a Farrell bag in the hospital but do not go home with them.

5. Patient will receive two extension sets a month. They can use one for 15 days and the other for 15 days or they can alternate daily.

6. Patient will receive 4 buttons a year

G-TUBE TEACHING PROCESS

1. Explain and have patient’s caregiver demonstrate the following:

   • Loading the feeding bag.

   • Loading the tubing into the pump.

   • Setting the rates and doses on the on the pump. (Note that the orders you received are probably not the orders that the patient will go home on. Teach the patient from the orders you have but also show them how to adjust rates from continuous to bolus feeds.)

2. Explain cleaning protocols and troubleshooting tips.

IF G-TUBE COMES OUT

1. Attempt to gently reinsert the button without applying force.

2. Tape over the button to keep it secure.

3. Take the patient directly to a children’s emergency room. (Patient needs to be at the hospital within about 2 hours after it comes out.)

4. Bring a spare button with you to the emergency room.

5. Inform the triage staff that the G-tube button has come out.

AFTER TEACHING

1. Ensure the caregivers understand and feel comfortable with the G-tube care steps.

2. Answer any additional questions

3. Provide contact information for follow-up assistance.

4. Check in with the patient’s nurse and report to them how the teach went.

5. If the Case Manager is available check in with them once the teaching has been completed.

6. Contact the CC ASAP on Teams and let them know how the teach went.

DOCUMENTATION

1. Complete all online documentation via Logiforms.

   • Select "ONLINE: Bedside Teach"
     

2. Document the button size & the name of the Case Manager in your narrative.

PRINTABLE GUIDE: