teaching project nursing 305

Running Head: Nasogastric Tube Teaching and Evaluation

Nasogastric Tube Teaching and Evaluation

Melissa B


A forty-seven year old African-American male presented in the Emergency Department last

week complaining of nausea, generalized abdominal pain and vomiting bright red blood. AA,

(patient reference) has an extensive medical history to include poorly controlled insulin-

dependent diabetes and uncontrolled hypertension directly resulting in renal failure requiring

dialysis. The Emergency Doctor ordered a nasogastric tube or NG tube to be inserted to assess

the gastrointestinal bleeding.

AA had never experienced hematemesis or a tube placed into his nose that went into his

stomach. After an informal conversation with AA about his background and reviewed medical

history, AA admits that personal healthcare had not been a priority for several years. AA also

explained that his lack of understanding the details of a nasogastric tube increased his anxiety

which directly heighted his fear of medical procedures. AA's learning according to the author,

Bastable (2008), " The prime motivator to learn in adulthood is to be able to apply knowledge

and skills for the solution of immediate problems." The abdominal pain and nausea motivated

AA to ask questions about nasogastric tubes and the relief provided by this intervention. The

purpose of this teaching session was to educate the patient about the nasogastric tube insertion.

Teaching would immediately be useful in reducing AA's stress and the physical discomfort the

patient was experiencing.

The fifteen minute teaching session included a short video demonstrating the NG insertion

step-by-step and access to supplies used in the procedure. These teaching aids were incorporated

in helping my patient to accomplish the following behavioral objectives:

1. After the completion of the fifteen minute teaching session the patient will identify the

equipment used for the nasogastric tube placement.


2. After watching a short video demonstrating the application of the nasogastric tube, patient

will admit to any fears associated with the procedure.

3. Following a demonstration of the head position required for nasogastric tube insertion, patient

will practice correct head position.

The first objective teaching strategy utilized the cognitive domain and the method of one on

one instruction with the use of teaching aids. Chapter 8 in Nurse as Learner and Teacher, Blais

and Hayes (2011) suggest, "Teaching aids can foster learning and help focus a learner's

attention," and continues on that "learning is more effective when learners are assisted to

discover the content for themselves." I presented the NG tube supplies on a bedside tray next to

AA along with a printed list of same. The seven pieces of equipment were named and located on

the list provided which took approximately six minutes. To evaluate the effectiveness of the

teaching I verbally quizzed the patient by holding up the individual supplies and listening to the

response.

The second objective teaching strategy involved using a multimedia presentation from the

Nursing-Resource.com website demonstrating nasogastric tube insertion, review of supplies and

requirements of the patient. The video is realistic by filming a patient experiencing the same

procedure and in a similar setting. The affective domain or "feeling" domain is accessed by

allowing AA to admit or discuss fears associated with the impending procedure. Bastable (2008)

believes, "Learner feelings or emotions cannot help but be aroused to some extent when exposed

to new and different educational experiences." This discussion lasted about five minutes and I

felt it allowed for an open dialogue between myself and AA which was the main purpose. This


domain is difficult to evaluate and Bastable (2008) explains "…affective behaviors are not

usually overt and clearly observable."

Lastly the psychomotor strategy or skill based teaching was implemented in the nasogastric

tube teaching session. This was a straightforward demonstration and return demonstration of the

head forward, chin-tuck position required to ease the passage of the NG tube into the esophagus.

In addition to the demonstration, Medscape.com provided an image depicting the required head

position. AA practiced this position on my cue for about four minutes. I maintained the

simplicity of this motor response and was careful not to integrate other domains in the patients

teaching. Psychomotor was evaluated on the observed return demonstration of hyperextension

of the head and chin.

The teaching session went well based on the evaluation of the behavioral objectives and the

goals perceived and met. It was rewarding to experience that using the domains as guides held

the patient's attention and perhaps invoked thoughtfulness into one's health. In the future, I

would pick a teaching subject with more web based patient teaching. I had a difficult time

finding web based teaching from other than a procedural perspective.


References

Bastable, Susan B. (2008). Nurse as Educator: Principles of Teaching and Learning for

Nursing Practice. 3rd ed. Sudbury, Massachusetts: Jones and Bartlett

Blais, K., Hayes, J.S. (2011). Professional Nursing Practice: Concepts and Perspectives. 6th ed.

Boston: Pearson

Nursing-Resource.com (2010, Feb. 15). NGT Insertion [Website]. Retrieved from

http://nursing-resource.com/ngt-insertion/#contents

Shlamovitz, G. (2014). Medscape [Website]. Retrieved from

http://emedicine.medscape.com/article/80925-overview#a15

teaching project nursing 305

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