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About The Course:

Jason, a 45-year-old male has recently undergone an abdominal surgery. As a postoperative procedure, his doctor has suggested an NG tube insertion to administer medication and nutrients, and facilitate gastric lavage.

A nasogastric tube or NG tube insertion procedure involves guiding a thin flexible tube into a patient’s stomach through the nostrils and esophagus. This essential nursing skill is not a very complicated procedure but still calls for precision and practice to avoid minor mistakes and further complications.

Learning Objective:
  • Practice explaining the procedure to a virtual patient
  • Gathering the required material for the procedure
  • Examining nostrils as preparation for insertion
  • Performing the insertion procedure
  • Using pH testing to confirm NG tube position
Reference:
  • Hodin, R. A., & Bordeiznou, L. Nasogastric and Nasoenteric Tubes. (2015). In: UpToDate, Sanfey, H., & Collins, K. A. (Eds.).
  • Wiegand, D. L. (2017). AACN Procedure Manual for High Acuity, Progressive, and Critical Care (7th ed.). St. Louis: Elsevier.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Eastern Virginia Medical School, Axon Park, MedVR Education and the Sentara Center for Simulation and Immersive Learning (SCSIL). Eastern Virginia Medical School is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation:
Eastern Virginia Medical School designates this Other activity (virtual reality and simulation) for a maximum of 1.0 AMA PRA Category1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Relevant Relationships:

All planning committee members and developers have disclosed they do not have any relevant relationships with ineligible companies.

Core Skills Training

Patient Preparation

For a patient, having a tube inserted into the nostril to be guided down the esophagus into the stomach can be a difficult procedure. It is the job of the practicing nurse to put the patient at ease and be prepared. As part of the Patient Preparation lesson, learners practice gathering required material, performing hand hygiene, informing the patient of the procedure, adjusting the bed height, examining the nostrils, and lubricating the tube for insertion. Detailed instructions are provided throughout the lesson for complete understanding.

NG Tube Insertion

Having gathered all the material and informed the patient of the procedure, the nurse is required to complete the insertion procedure. As part of this lesson, learners perform tasks like inserting the tube, instructing the patient to take small sips of water, checking correct placement of the tube, performing the ‘whoosh’ test, and securing the tube to the patient’s nose. Learners are helped with detailed instructions at every step of the process. Physics-based interactions and haptic feedback provide real-world like experiences, helping learners gain a better understanding of their performance and effects of their actions. Instant feedback helps identify mistakes and instantly rectify them.

Training

With prompts, guidance and affordances learners are hand-held through the process to practice the procedure in a virtual environment with a virtual patient.

  • Photorealistic Virtual Environment
  • Physics-based Interactions
  • Learn by Doing
  • Visual Affordances

Assessment

Test skills to perform the procedures from start to finish without prompts. An incorrect step will take the learner back to the start to start afresh.

  • Live Scoring
  • Instant Feedback
  • Unlimited Practice Sessions
  • LMS Integration