Gastrostomy (G, GJ, J) Complications — Sample ISBARQ — Clinical Pathway: Inpatient

G, GJ, J Tube Complications Clinical Pathway — Inpatient

Sample ISBARQ

Introduction: Hi my name is (name)____ and I am the ____(role)____ caring for _______(patient name)_________.

Situation: On exam, I discovered the patient’s tube site has _____________(Condition) ______________ and I was looking for management guidance.

Background: This is a patient with the following pertinent history: _____________________________________ whose tube was placed by (service) ______________ on (date) __________________________. This is an (initial or replacement) tube and was last changed on (date).

Assessment: (more detail on the condition of the tube site and the specific problems going on with it, any relevant patient assessments such as fever, as well as current treatments and anything that’s been tried)

Recommendation: (what is the caller looking for, a bedside exam from the service managing the tube? Over the phone recommendations?)

Questions: what other information can I provide you? (Tube type, tube size, balloon volume, securement detail, current feeds bolus/continuous/volume, venting? etc.)

Example

Hi my name is Ron and I'm the nurse caring for John Doe on 5 South. He is a 10-year-old male with a history of feeding difficulties and poor weight gain. He had a G-tube surgically placed by General Surgery in 2015 here at CHOP. The tube is established and was last changed 3 weeks ago. A few days ago, some redness started around the tube. It is continuing to look worse so we would like some recommendations from your team.

Right now the site looks red and it looks like some granulation tissue may be forming. We've been applying Desitin as a barrier cream, but there has been no improvement to the redness over the past 48 hours. Our team is concerned that this may be a cellulitis. We would also like someone to assess the granulation tissue.

The tube is 14 Fr 2.0cm AMT Mini-One button. The balloon has 4 mL of water in it and his parents generally use a single split gauze under the tube, with no tape or adhesives. He is currently getting continuous overnight feeds and is tolerating them well.