In the Fine-Bore Nasogastric (NG) Tube Insertion station of the NMC OSCE, candidates often make several common mistakes that can result in failure. Avoiding mistakes in the Fine-Bore Nasogastric (NG) Tube Insertion station requires proper preparation, technique, and adherence to safety protocols. Follow these steps to ensure success:
1. NMC OSCE Fine-bore Nasogastric tube insertion: Lack of Proper Preparation
- Not performing hand hygiene before and after the procedure.
- Not obtaining informed consent from the patient before starting.
- Not assessing for contraindications (e.g., nasal obstruction, recent nasal trauma, severe coagulopathy).
- Not checking Integrity of all equipment is prepared, including a fine-bore NG tube, lubricant, pH indicator strips, a 50ml syringe, gloves, and a documentation sheet.
2. NMC OSCE Fine-bore Nasogastric tube insertion: Poor Aseptic Technique
- Not wearing gloves appropriately during the procedure.
- Touching the tube excessively without maintaining cleanliness.
3. NMC OSCE Fine-bore Nasogastric tube insertion: Incorrect Measurement of the Tube
- Not measuring from the tip of the nose to the earlobe to the xiphisternum (NEX method) correctly. Use the NEX method (Nose → Earlobe → Xiphisternum) to measure the correct insertion depth.
- Not marking the correct insertion depth on the tube.
4. NMC OSCE Fine-bore Nasogastric tube insertion: Incorrect Insertion Technique
- Not lubricating the tube adequately, causing discomfort to the patient.
- Using force during insertion, which can lead to nasal trauma.
- Not positioning the patient properly (patient should be sitting semi-upright with head slightly tilted forward).
- Not asking the patient to swallow water or dry swallow while advancing the tube to aid passage.
5. NMC OSCE Fine-bore Nasogastric tube insertion: Verification and Confirmation Errors
- Not checking for signs of incorrect placement (e.g., coughing, distress, difficulty speaking).
- Failing to aspirate gastric contents for pH testing.
- Not using pH strips correctly or not waiting for the proper pH reading (should be ≤5.5 for confirmation).
- Failing to document tube placement before administering any feed or medication.
6. NMC OSCE Fine-bore Nasogastric tube insertion: Poor Communication
- Not reassuring or explaining the procedure to the patient throughout.
- Ignoring signs of discomfort or distress during insertion.
7. NMC OSCE Fine-bore Nasogastric tube insertion: Safe Disposal and Closing
- Dispose of used equipment appropriately.
- Remove gloves and apron, and perform hand hygiene.
- Ensure patient comfort and safety before leaving.
Quick Key Points for NMC OSCE Fine-bore Nasogastric tube insertion station;
1. Introduce yourself and gain consent from the patient before starting.
- Hand Hygiene & PPE – Follow infection control protocols.
- Check integrity of Equipment – Check expiry date, packaging integrity, and sterility. Ensure Working Oxygen and Suction Machine present near patient.
- Position for Procedure; Ensure semi-upright position and check patency of Nostril. Instruct patient to raise hand if any discomfort during procedure. Take NEX measurement.
- Tube Insertion- Lubricate and Ensure to insert tube in backward and inward manner along with Nose to Nasopharynx while checking patient comfort.
- Administer Fluids/Nutrition Correctly: Enteral Feeding (NG Tube): Confirm tube placement (pH test). Ensure to check tube position before each feed. If required send to radiology.
- Ensure to Give Health Education; Not to pull Tube, Regular mouth care etc.
- Dispose of Equipment Safely – Follow infection control measures. Discard used items appropriately.
- Ensure Patient Comfort & Safety – Reassess patient before leaving.
In NMC OSCE Fine-bore Nasogastric tube insertion station, you need to demonstrate safe and accurate administration of fluids and nutrition, ensuring patient safety and adhering to best practices. By following these structured steps, you can minimize errors and successfully demonstrate safe practice in the NMC OSCE Fine-Bore Nasogastric (NG) Tube Insertion station in exam.
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