G, GJ, J Tube Complications Clinical Pathway – Inpatient

Related Pathways

GJ or G Tube Displacement

Inpatient with a Percutaneous or Surgical G, GJ or J Tube
and Suspected Site Complication

Identify the tube type and maturity of stomal tract in LDA

Verify that the info in LDA is up to date and accurate

Local resources for support include:
- CNS
- Skin Champion
- APP

Bedside Team Completes the Following Steps

Clean the stoma and site
Perform comprehensive assessment
- Check the tube fit (tight vs. loose)
- Document the site assessment in LDA
- Document the site with images in Media tab

Erythema

Irritant Dermatitis

Leaking

Enlarged Stoma/Keyhole

Differentiating Granulation
Tissue from Prolapse

Granulation Tissue

Prolapse

If no improvement following bedside treatments, contact the appropriate service

PHL
Type of Tube	Contact via Epic Secure Chat
Initial and Replacement G Tubes/ J Tubes Placed by General Surgery	Contact General Surgery for problems with these tubes: Weekdays between 9 a.m. – 4:30 p.m.: PHL Gen Surg Gtube in Epic On-Call Finder If NP in General Surgery is not available: Gen Surg Cnslt ED/IP in On-Call Finder For PHL NICU: Contact PHL NICU Green FLOCs via Epic Chat
Initial G Tubes Placed by IR and All GJ Tubes	Contact IR for problems with these tubes Weekdays 7 a.m. – 5 p.m. PHL IR FLOC
Replacement G Tubes That Were Initially Placed by IR	Contact PHL Wound Ostomy Gtube Consult Monday – Friday: 8 a.m – 4:30 p.m.
Replacement G Tubes That Are Currently Followed by GI
All Tubes Placed Outside of CHOP and Not an Established Patient with General Surgery or GI	Contact PHL Wound Ostomy Gtube Consult Contact General Surgery on Nights/Weekends/Holidays

KOPH
Type of Tube	Contact via Epic Secure Chat
Initial G Tubes Placed by IR and All GJ Tubes	Contact IR for problems with these tubes: Weekdays 7 a.m. – 5 p.m. PHL IR FLOC
Replacement G Tubes Placed by IR	Consult KOPH Gen Surg Cnslt 1st Contact via Epic Chat
All Tubes Placed by General Surgery
All Tubes Placed Outside of CHOP

Posted: May 2019
Last Revised: May 2025

Authors:
- M. Stetzer, CWOCN;
- C. Ehritz, ACCNS-P;
- A. Boroughs, CWOCN;
- M. Boettcher, CRNP;
- S. Amato-Rotkowitz, PA-C;
- K. Anderson, PA-C;
- T. Walker CRNP;
- K Vogel, RN;
- L. Agzigian, CRNP;
- L. Kurowsky, CRNP;
- M. Ryan, MD;
- P. Laje, MD;
- A. Srinivasan, MD;
- P. Reynolds, RN

Editors: Clinical Pathways Team

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Clinical Pathway for Management of Gastrostomy Tube Complications

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