Office of Health Professionals Regulation

Board of Nurse Registration and Nursing Education

Policy Statement on Reinsertion of endoscopically or surgically placed feeding tubes [e.g. G Tube] by the professional registered nurse

The Boards of Medical Licensure and Discipline and Nurse Registration and Nursing Education, and the Office of Facilities Regulation have determined the standard of care regarding reinsertion of an endoscopically or surgically placed feeding tube by the professional nurse is as follows:

1. The nurse shall inform the physician prior to reinsertion, and before resumption of feeding. The nurse must document the procedure in the medical record.

2. Within 30 days of initial placement [i.e., a “fresh” tube]: a nurse shall not reinsert the tube.

3. After 30 days from initial placement [i.e., a “mature” tube]: the tube may be reinserted by a nurse [RN] who has been deemed competent to perform the specific procedure by the facility or home care organization.  The nurse shall discontinue an attempted reinsertion if undue resistance is encountered.  The nurse shall confirm successful reinsertion by appropriate methods [e.g., pH testing of aspirated gastric contents, radiographic imaging] that are in concordance with written facility/agency policies and procedures.

Health care entities that treat patients with chronic G Tubes shall have a policy that stipulates the minimum training requirements, competency assessment of nurses for performing these procedures, and protocols for care of patients with endoscopically or surgically placed feeding tubes.