- A pump must be used for Jejunostomy tube feedings
- You CANNOT bolus feed into a jejunostomy tube
Considerations:
- Be sure to take steps to ensure patient privacy when performing procedure
- The unlikely risk with jejunostomy tube feedings is aspiration of formula into the lungs, be sure the student is positioned properly with head elevated at least 30 degrees
- Discuss with the student’s health care provider:
- What the procedure should be if the Jejunostomy tube were to be dislodged while the student was at school
- How tube placement should be verified prior to feeding
- If the student should have decompression before/during feeding
- Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
Supplies:
- Adaptor/extension with tubing and clamp
- Feeding solution in can/container at room temperature
- Feeding bag
- 60-mL ENFit/enteral syringe
- Enteral pump
- Warm tap water, if prescribed
- Pole to hold feeding container, if applicable
- For ease of portability, student may use a backpack to carry pump and feeding bag
- Student’s Individualized Health Plan (IHP) and healthcare provider’s orders
- Parent/Guardian authorization form
Procedure:
- Review healthcare provider’s order including:
- the type of formula
- amount
- infusion type and rate
- frequency of administration
- residual volume checks
- amount of water used to flush the tube
- Review student’s allergy status
- Ensure proper documentation of parent/guardian authorization to administer the feeding
- Explain the procedure to child at his/her level of understanding
- Wash hands
- Assemble equipment and place on a clean surface
- Confirm you have the correct formula
- Check expiration date on formula
- Note the integrity of the formula container
- Put on gloves
- Position child either sitting or supine with head up at least 30 degrees
- Ensure that the clamp is not resting on the student’s skin
- Observe abdomen for signs of tube malposition or obstruction/clogging of jejunostomy tube such as difference in external tube length compared to baseline measurements or abdominal distention
- If student has abdominal distention do not administer feeding and contact parent/guardian and healthcare provider
- Shake the feeding can/container
- If feeding is in a can, clean the top of the feeding (formula) can with an alcohol wipe or soapy cloth
- Measure prescribed amount of enteral formula to be infused into a clean graduated measuring cup
- Observe the appearance of the formula for abnormalities
- Prepare the enteral formula per healthcare provider’s order
- Pour feeding into feeding bag
- Run feeding through tubing to the tip and the extension tubing and clamp the tubing
- Hang container on pole (of place in student’s backpack, if applicable)
- Turn on pump
- Place tubing into pump and set flow rate
- Zero the volume delivery amount on the enteral pump
- Open safety plug and insert tubing into the J-tube
- Open clamp on tubing
- Start the feeding pump at the prescribed rate
- When prescribed volume of feeding is completed, clamp feeding bag tubing and remove
- Check the volume delivered on the pump to ensure the proper amount of formula was infused
- Remove plunger from 60-mL ENFit/enteral syringe
- Attach ENFit/enteral syringe
- Flush tubing with 5ml of water or prescribed amount
- Disconnect ENFit/enteral syringe and extension tubing
- Cap J-tube
- Keep the child in a feeding (upright) position for at least 30 minutes after completing feeding, if required
- Wash syringes and tubing with soap and warm water and put in home container
- Syringes and feeding extension tubing can be used repeated times for up to 24 hours
- Remove gloves
- Wash hands
- Document assessment, interventions, and outcomes in student’s healthcare record
- Follow up with parents/guardian and healthcare provider, as needed
References:
Boullata, J. I., Carrera, A. L., Harvey, L., Escuro, A. A., Hudson, L., Mays, A., McGinnis, C., Wessel, J. J., Bajpai, S., Beebe, M. L., Kinn, T. J., Klang, M. G., Lord, L., Martin, K., Pompeii-Wolfe, C., Sullivan, J., Wood, A., Malone, A., Guenter, P., & ASPEN Safe Practices for Enteral Nutrition Therapy Task Force, American Society for Parenteral and Enteral Nutrition. (2017). ASPEN safe practices for enteral nutrition therapy [Formula: see text]. JPEN. Journal of parenteral and enteral nutrition, 41(1), 15–103. https://doi.org/10.1177/0148607116673053
Perry, A. G., Potter, P.A., Ostendorf, W., & Laplante, N. (2021). Skill 32.4 administering enteral nutrition: Nasogastric, nasointestinal, gastrostomy, or jejunostomy tube. In Clinical nursing skills and techniques. (10th ed.). (pp. 965-972). St. Louis, MO: Elsevier.
Porter, S. M., Page, D., Engholm. H., & Somppi, C. (2019). Students supported by medical technology. In J. Selekman, Shannon, R.A., Yonkaitis, C.F. (Eds.). School nursing, a comprehensive text (3rd ed., pp. 721-740). Philadelphia PA.: F. A. Davis Co.
Spratling, R., Chambers, R., Lawrence, P., & Faulkner, M.S. (2021). Best practices with use of feeding tubes for children at home. Pediatric Nursing, 47(1), 7-10.
Toothaker, R., & Cook, P. (2018). A review of four health procedures that school nurses may encounter. NASN school nurse (Print), 33(1), 19–22. https://doi.org/10.1177/1942602X17725885
Page last reviewed: February 14, 2025
Page last updated: February 14, 2025
The information and materials presented in this Website are intended for informational purposes only and are not designed to diagnose or treat a health problem or disease, or assist in diagnosis or treatment of the same. The information is not intended to substitute for, supplement or replace clinical judgment. If there are any concerns or questions about or relating to a nursing or medical procedure, contact the individual’s healthcare provider. The information provided on this Website is not intended to be a substitute for medical orders and persons without the proper education, training, supervision and/or licensure should not perform the procedures.