Providing Nutrition to the Patients - Essay Example

Teaching Nasogastric Tube Feeding Introduction Providing nutrition to the patients is an very essential aspect of patient care. One of the meansof providing nutrition is nasogastric tube feeding. Feeding through nasogastric tube is known as nasogastric tube feeding. Nasogastric tube or NG tube is a small tube that is inserted into the stomach through nose. It is most commonly used in newborns, infants and children for introduction of feeds into the stomach when they are unwell. It can be used in adults also with appropriate size use. Breast milk, formula feeds or liquid food is introduced into the stomach directly through this tube (Shlamovitz and Shah, 2010). The tube serves several other purposes like aspiration of gastric fluids, gastric decompression and several other diagnostic and therapeutic purposes. Introduction and positioning of nasogastric tube is inconvenient to the patient and care must be taken to introduce the tube properly and put it in the right position. The tube should not be introduced into the trachea or leave it just in the esophagus. After insertion of the tube, proper placement of the tube must be verified either pushing 60 ml of air through the tube and by auscultating air gush over stomach or by aspirating gastric contents. The tube should be secured only after confirming proper positioning. Appropriate training and experience is essential for safe, secure and comfortable insertion of nasogastric tube. The type, frequency and duration of feeds introduced through the nasogastric tube depends on the age and clinical condition of the patient. The feeding may be continuous or intermittent. Thus, it is very important for nurses administering nasogastric tube feeding to possess adequate knowledge and expertise while inserting the tube and delivering feeds. In this essay teaching of nasogastric tube feeding will be elaborated using a suitable teaching model. Aims and objective of teaching nasogastric tube feeding in the clinical setting The aim of this teaching session is to enhance the knowledge of the nurse pertaining to introduction of nasogastric tube and delivery of feeds through it. The objectives are to teach the nurses to introduce nasogastric tube into the right place with minimal discomfort to the patients, to initiate and maintain different types of feeds through the tube in different age groups, to prevent complications of nasogastric tube feeding and to identify complications and intervene early. Thus the ultimate aim of this clinical education is optimum patient care. In order to impart appropriate training, the clinical educator must following proper teaching standards, possess adequate competence and deliver information and training in a stress-free environment through stress-free methods. As Rose and Best (2005) opined, clinical education can be improved using appropriate planning, structuring of the various sessions, integration of clinical practicum and progression in this regard. Models of learning: Constructivism In this teaching session, procedural instruction will be imparted through traditional method of education. Thereafter, principles of Constructivist Learning Theory will be used to deliver teaching. According to this theory, "learning is an active process in which learners construct new ideas or concepts based upon their current/past knowledge. The learner selects and transforms information, constructs hypotheses, and makes decisions, relying on a cognitive structure to do so" (Bruner, 1996). Teaching strategies and rationale Thus, to facilitate constructivism, teachers must accept and encourage the initiatives and autonomy of the students during the process of learning and various interactive, manipulative, physical and raw data from primary sources must be used for training. preference must be given for various cognitive terms like "predict", "create", "classify" and "analyse" while assigning tasks to students. The students must be encouraged to communicate, inquire and apply critical thinking for leaning (NDT Resource Center, n.d.). "On-the-spot" decisions about behaviours of the teachers, strategies for instructions, various teaching activities and content to be taught must be made based on the student responses. Communication between students and between teachers and students must be encouraged. The teachers must put follow-up questions and after the initial response from the students, elaboration must be sought. The students must be put in situations that challenge various conceptions which have been there previously, so that contradictions develop which provide fuel and scope for discussion. Enough time must be provided for the students to construct the meaning of the subject in their own sense in the process of learning a new thing (Brooks and Brooks, 1993). Teaching of nasogastric tube feeding will involve both theoretical and practical aspects. A time-table is set in for the teaching session on the notice board and students are advised to come prepared for the sessions based on the time table. The first session will constitute of information regarding the procedure in a traditional way. Information from the students which they gained from different their readings will be shared. Students will also be encouraged to talk openly about what they expect from the teaching session. Students will be encouraged to form their own questions and impart information as to what they have gathered during their individual learning. Emphasis will be laid on the types of nasogastric tubes, the sizes, methods of insertion in all age groups, the need to apply lubrication prior to insertion, strategies to minimise discomfort and optimise optimum placing, types of feeds that can be delivered through tubes, preparation of those feeds and other purposes of nasogastric tubes will be covered. The next 2 sessions will be about practical experience. Students will be taught how to insert nasogastric tube practically. Opportunity will be given to the students to get hands-on-experience based on the opportunities available. Techniques to insert nasogastric tube in a comfortable manner will be taught practically. Students will be encouraged to give their opinions and ask doubts regarding the technique and its implications. The fourth session will include administration of a questionnaire, to ascertain and evaluate the understanding and assimilation of the subject by the students. the session will end with discussion of doubts. A summary of what is taught will be presented in the end (McTaggart, 1997). Outcomes of the learning The students must be able to perform insertion of the nasogastric tube in all age groups by causing minimal discomfort to the patient and place the tip in the optimum position for administration of feeds. They must be able to deliver age appropriate feeds as per the instructions of the clinician. Student evaluation Evaluation will be done after a few days, like after a week to determine the level of learning. Self assessment of the teacher Assimilation of the knowledge by the student depends not only on the student, but also on the teacher. Thus it is important for the teacher to evaluate one-self. Such an evaluation is possible by viewing the examination papers of his/her students. Reflection, based on the papers helps the teacher adopt to different strategies while teaching next batches. The teacher can clarify on the parts in which the students have failed or have not performed well (Bradshaw, M., & Lowenstein, 2006). Conclusion Students can be taught about nasogastric feeding using traditional and constructivism methods of teaching which helps in active learning through cognition methods. References Bradshaw, M., & Lowenstein, A. (2006). Innovative Teaching Strategies in Nursing and Related Health Profession. London: Jones and Bartlett Publishers. Brooks, J. and Brooks, M. (1993). In Search of Understanding: The Case for Constructivist Classrooms, ASCD) Bruner, J. (1996). The Culture of Education, Cambridge, MA: Harvard University Press. McTaggart, R. (1997). Participatiry Action Research. New York:Sunny Press. NDT Resource Center. n.d. Teaching with the Constructivist Learning Theory. Retrived on 19th August 2010 from http://www.ndt-ed.org/TeachingResources/ClassroomTips/Constructivist%20_Learning.htm. Rose, M. and Best, D., (2005). Transforming practice through clinical education, professional supervision, and mentoring. Elsevier Health Sciences. Shlamovitz, G.Z., Shah, N.R. (2010). Nasogastric tube. Emedicine from WebMD. Retrived on 19th August 2010 from http://emedicine.medscape.com/article/80925-overview Read More