Goal: The tube maintains patency with irrigation and patient remains free from injury.
1. Assemble equipment. Verify the medical order or facility policy and procedure regarding frequency of irrigation, solution type, and amount of irrigant. Check expiration dates on irrigating solution and irrigation set.
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. Perform key abdominal assessments as described above.
5. Pull the patient’s bedside curtain. Raise bed to a comfortable working position, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009). Assist patient to 30- to 45-degree position, unless this is contraindicated. Pour the irrigating solution into container.
6. Put on gloves. Check placement of NG tube. (Refer to Skill 11-2.)
7. Draw up 30 mL of saline solution (or amount indicated in the order or policy) into syringe.
8. Clamp suction tubing near connection site. If needed, disconnect tube from suction apparatus and lay on disposable pad or towel, or hold both tubes upright in nondominant hand.
9. Place tip of syringe in tube. If Salem sump or doublelumen tube is used, make sure that syringe tip is placed in drainage port and not in blue air vent. Hold syringe upright and gently insert the irrigant (or allow solution to flow in by gravity if agency policy or physician indicates). Do not force solution into tube.
10. If unable to irrigate tube, reposition patient and attempt irrigation again. Inject 10 to 20 mL of air and aspirate again. Check with physician or follow agency policy, if repeated attempts to irrigate tube fail.
11. After irrigant has been instilled, hold end of NG tube over irrigation tray or emesis basin. Observe for return flow of NG drainage into available container. Alternately, you may reconnect the NG tube to suction and observe the return drainage as it drains into the suction container.
12. If not already done, reconnect drainage port to suction, if ordered.
13. Inject air into blue air vent after irrigation is complete. Position the blue air vent above the patient’s stomach.
14. Remove gloves. Lower the bed and raise side rails, as necessary. Assist the patient to a position of comfort. Perform hand hygiene.
15. Put on gloves. Measure returned solution, if collected outside of suction apparatus. Rinse equipment if it will be reused. Label with the date, patient’s name, room number, and purpose (for NG tube/irrigation).
16. Remove gloves and additional PPE, if used. Perform hand hygiene.
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