Gastrostomy Tubes

Role of the Registered Professional Nurse in the Coordination and Oversight of Unlicensed Assistive Personnel (UAP) regarding Gastrostomy Tubes (G-Tubes)

The Maine State Board of Nursing issues this Position Statement to guide the practice of nursing. The Board's primary concern is the health and safety of consumers.

The purpose of this position statement is to provide guidelines/criteria that define the conditions under which the registered professional nurse (RN) may coordinate and oversee the task of
G-tube care to UAP in populations with developmental disabilities. In certain circumstances the RN may coordinate and oversee the execution of tasks related to G-tube maintenance, feeding, and administration of prescribed medications.

The RN must complete a thorough assessment of the consumer's nursing care needs, taking into consideration the consumer's overall medical condition. Assessment of the consumer's need related to the G-tube includes the condition of the G-tube (e.g., the maturity of the stoma site, patency, and sustained skin integrity) and designating the appropriate care giver. The RN is responsible for communication and consultation regarding provision of G-tube services.

All UAP providing G-tube care must be at a minimum Certified Residential Medication Aides (CRMA).

The RN is responsible to develop an instructional plan for the UAP and maintain documentation of instructional activities. Part of the instructional plan shall include a mechanism to evaluate competency.

Individual written plans that address the consumer's needs must be available for the UAP at the site at which care is rendered. Information must be updated as needed The plan must include contingency provisions to address unexpected G-tube occurrences.

If the stability of staffing patterns changes within a program providing G-tube care
and consumer safety can no longer be ensured, the RN has the authority in accordance with Chapter 6 Regulations Relating to Coordination and Oversight of Patient Care Services by Unlicensed Health Care Assistive Personnel to determine whether or not the UAP may continue to provide G-tube care to the specific consumer and report this determination to the administration of the organization.

Approved by Board of Nursing March 1-2, 2006