Jejunostomy Tube Continuous Feeding

<< DIGESTIVE

  • 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
  • Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills

Supplies:

  • Adaptor with tubing and clamp
  • Feeding solution in container (bag) at room temperature
  • 60 ml syringe
  • 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/or healthcare provider’s orders
Procedure Download
Skill Competency Download

Procedure:

  1. 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
  2. Explain the procedure to child at his/her level of understanding
  3. Wash hands
  4. Assemble equipment and place on a clean surface
  5. Position child either sitting or supine with head up at least 30 degrees
  6. Ensure that the clamp is not resting on the student’s skin
  7. Put on gloves
  8. 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
  9. Pour feeding/fluids into feeding container, run feeding through tubing to the tip and clamp tubing
  10. Hang container on pole (of place in student’s backpack, if applicable)
  11. Place tubing into pump and set flow rate
  12. Open safety plug and insert tubing into the J-tube
  13. Open clamp on tubing
  14. Start the feeding pump at the prescribed rate
  15. When prescribed volume of feeding is completed, clamp feeding bag tubing and remove
  16. Remove plunger from syringe
  17. Attach syringe and flush tubing with 5ml of water or prescribed amount
  18. Disconnect syringe
  19. Cap J-tube
  20. Keep the child in a feeding (upright) position for at least 30 minutes after completing feeding, if required
  21. 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
  22. Remove gloves
  23. Wash hands
  24. Document assessment, interventions, and outcomes in student’s healthcare record
  25. Follow up with parents/guardian and healthcare provider, as needed

References:

Bowden, V. R., & Greenberg, C. S. (2016). Pediatric nursing procedures (eBook) (4th Edition). Philadelphia: Wolters Kluwer Health.

Connecticut State Department of Education. (2012). Clinical Procedure Guidelines for Connecticut School Nurses. Available at:
http://www.sde.ct.gov/sde/lib/sde/pdf/publications/clinical_guidelines/clinical_guidelines.pdf

Porter, S., Haynie M.D., Bierle, T., Caldwell, T. & Palfrey, J.  (1997).  Children and Youth Assisted by Medical Technology in Educational Settings.  Guidelines for Care.  Second Edition.  Paul H. Brookes Publishing Co., P.O. Box 10624, Baltimore, MD 21285-0624

Simons, S., Remington , R.  (2013).  The Percutaneous Endoscopic  Gastrostomy Tube: A Nurse’s Guide to PEG Tubes.  MedSurg Nursing; 22(2):77-83.

University of Wisconsin Hospitals and Clinics.  (2012).  Caring for Your J-tube.  Available at: http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember-Show_Public_HFFY_1104449363413.html

Acknowledgment of Update Reviewer:

Marcy Weidkamp, APNP
Pediatric Gastroenterology
American Family Children’s Hospital

Acknowledgment of Initial Reviewers:

Lori A. Duesing, MSN, RN, CPNP-AC
Advanced Practice Nurse
Department of Gastroenterology
Children’s Hospital of Wisconsin

Kathy Leack, MS, RN, CNS
Advanced Practice Nurse
Children’s Hospital of Wisconsin

Page last reviewed: September 20, 2021
Page last updated: September 20, 2021

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.