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FUNDAMENTAL OF NURSING PRACTICE SKILL EVALUATION TOOL
Name of Student: ________________________________________ Student Number: ______________
Year/Clinical Group ___________ School Year: ______________ Term: _________
Inclusive Dates of Clinical Rotational: ____________________________

General Instructions: Please put a check (/) for the procedures performed and (X) for the not performed procedures by
the student. Each check has a corresponding point of 1.

OBE CODE PROCEDURE: ADMINISTERING A TUBE FEEDING

Performed Comments
Preparation
Yes No
1. Needed equipment/materials:
• Correct amount of feeding solution
• 60-ml catheter-tip syringe
• Emesis basin
• Clean gloves
• pH strip or meter
• Large syringe or calibrated plastic feeding bag with label and
tubing.
• Measuring container from which to pour the feeding.
• Water at room temperature (60 ml, unless otherwise specified)
• Feeding pump as required
2. Assess:
• For any clinical signs of malnutrition or dehydration.
• For allergies to any food in the feeding for the presence of bowel
sounds.
• For any problems that suggest lack of tolerance of previous
feedings

3. Determine:
• Type, amount, and frequency of feedings.
• Tolerance of previous feedings.
4. Assist the client to a Fowler’s position in bed, or a sitting position
in a chair. If a sitting position is contraindicated, a slightly elevated
right side- lying position is acceptable.
ASSESSMENT PROCEDURE
1. Greet the client and introduce yourself.
2. Explain to the client what you will do, why it is necessary, and how he can
cooperate.
3. Wash hands and observe appropriate infection control procedures
4. Provide for client privacy.
5. Assess tube placement.
Attach the syringe to the open end of the tube, and
aspirate. Check the pH.
• Allow 1 hour to elapse before the pH, if the client has received a
medication.
 • Use a pH meter rather than pH paper, if the client is receiving a
continuous feeding.
If the tube was placed in the stomach, aspirate all contents, and measure
the amount before administering the feeding.
If 100 mL (or more than half of the last feeding) is withdrawn, check with
the nurse in charge or refer to agency policy before proceeding.
Reinstill the gastric contents into the stomach, if this is the agency policy
or the primary care provider’s order.
If the client is on a continuous feeding, check the gastric residual every 4-
6 hours or according to agency protocol.
6. Administer the feeding.
Before administering feeding:
• Check the expiration date of the feeding.
• Warm the feeding to room temperature.
When an open system is used, clean the top of the feeding container with
alcohol before opening it.
Feeding Bag (Open System)
Clamp the tubing, and add the formula to the bag.
Hang the labeled bag from an infusion pole about 30 cm (12 inches) above
the tube’s point of insertion into the client.
Open the clamp, run the formula through the tubing, and reclamp the tube.
Attach the bag to the feeding tube, and regulate the drip by adjusting the
clamp to the drop factor on the bag, if not placed on a pump.
Syringe (Open System)
Remove the plunger from the syringe, and connect the syringe to a
pinched or clamped nasogastric tube
Add the feeding to the syringe barrel.
Permit the feeding to flow in slowly at the prescribed rate. Raise or lower
the syringe to adjust the flow as needed. Pinch or clamp the tubing to stop
the flow for a minute, if the client experiences discomfort.
Prefilled Bottle with Drip Chamber (Closed System)
Remove the screw-on cap from the container, and attach the
administration set with the drip chamber and tubing.
Close the clamp on the tubing.
Hang the container on an intravenous pole about 30 cm (12 inches) above
the tube’s insertion point into the client.
Squeeze the drip chamber to fill it to / to / of its capacity.
Open the tubing clamp, run the formula through the tubing, and reclamp
the tube.
Attach the feeding set tubing to the feeding tube, and regulate the drip rate
to deliver the feeding over the desired length of time or attach to a feeding
pump.
7. If another bottle is not to be hung immediately, flush the feeding tube
immediately before all of the formula has run through the tubing.
Instill 50-100 ml of water through the feeding tube or medication port
Be sure to add the water before the feeding solution has drained from the
neck of a syringe or from the tubing of an administration set.
8. Clamp the feeding tube.
Clamp the feeding tube before all of the water is instilled.
9. Ensure client comfort and safety.
Secure the tubing to the client’s gown.
Ask the client to remain sitting upright in Fowler’s position or in a slightly
elevated right lateral position for at least 30 minutes.
 Check the agency’s policies on the frequency of changing the nasogastric
tube and the use of smaller-lumen tubes, if a large-bore tube is in place.
10. Dispose of equipment appropriately.
If the equipment is to be reused, wash it thoroughly with soap and water,
so that it is ready for reuse.
Change the equipment every 24 hours, or according to agency policy.
11. Document all relevant information.
Document the feeding, including amount and kind of solution taken,
duration of the feeding, and assessments of the client.
Record the volume of the feeding and water administered on the client’s
intake and output record.
12. Monitor the client for possible complications.
Carefully assess clients receiving tube feedings for problems
To prevent dehydration, give the client supplemental water in addition to
the prescribed tube feeding, as ordered.
VARIATION: Continuous-Drip Feeding
13. Clamp the tubing at least every 4-6 hours or as Indicated by agency
protocol or the manufacturer, and aspirate and measure the gastric
contents. Then flush the tubing with 30-50 ml of water.
14. Determine agency protocol regarding withholding a feeding.
15. To prevent spoilage or bacterial contamination, do not allow the feeding
solution to hang longer than 4-8 hours.
16. Follow agency policy regarding how frequently to change the feeding bag
and tubing.
REMARKS
TOTAL POINTS

Computation: Total number of points acquired by the student / Total Number of points for the procedure = Total points in
percentage

Remarks:

Passed (75 – 100%)

Annotation
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Conforme: ___________________________________ Clinical Instructor: _______________________________

Student’s Over Printed Name and Signature Over Printed Name and Signature