Caring for a Gastrostomy Tube

Goal: The patient ingests an adequate diet and exhibits no signs and symptoms of irritation, excoriation, or infection at the tube insertion site.

1. Assemble equipment. Verify the medical order or facility policy and procedure regarding site care.

2. Perform hand hygiene and put on PPE, if indicated.

3. Identify the patient.

4. Explain the procedure to the patient and why this intervention is needed. Answer any questions as needed.

5. Assess patient for presence of pain at the tube insertion site. If pain is present, offer patient analgesic medication per physician’s order and wait for medication absorption before beginning insertion site care.

6. Pull the patient’s bedside curtain. Raise bed to a comfortable working position, usually elbow height of the caregiver (VISN 8, 2009).

7. Put on gloves. If gastrostomy tube is new and still has sutures holding it in place, dip cotton-tipped applicator into sterile saline solution and gently clean around the insertion site, removing any crust or drainage. Avoid adjusting or lifting the external disk for the first few days after placement except to clean the area. If the gastric tube insertion site has healed and the sutures are removed, wet a washcloth and apply a small amount of soap onto washcloth. Gently cleanse around the insertion, removing any crust or drainage. Rinse site, removing all soap.

8. Pat skin around insertion site dry.

9. If the sutures have been removed, gently rotate the guard or external bumper 90 degrees at least once a day. Assess that the guard or external bumper is not digging into the surrounding skin. Avoid placing any tension on the feeding tube.

10. Leave the site open to air unless there is drainage. If drainage is present, place one thickness of precut gauze pad or drain sponge under the external bumper and
change as needed to keep the area dry. Use a skin protectant or substance such as zinc oxide to prevent skin breakdown.

11. Remove gloves. Lower the bed and assist the patient to a position of comfort as needed.

12. Remove additional PPE, if used. Perform hand hygiene.