Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [126], C).
2. 2.Show
   Decontaminate hands and apply personal protective equipment.
   To minimize the risk of cross‐infection ([115], C).

Procedure

1. 3.Show
   Remove the existing dressing if in place. Observe the peristomal skin and stoma for signs of infection, erythema, irritation or excoriation. Observe the tube and consider how it is being kept in place, and note the presence of any sutures or external fixation plates. Refer to guidance from gastroenterologists for care of sutures.
   To gain access to the stoma site. To detect complications early and instigate appropriate treatment (Lynch and Fang [92], R). To minimize the risk of accidental displacement of the tube. E
2. 4.Show
   Clean the stoma site with sterile solution, such as 0.9% sodium chloride, using a circular outward motion.
   To minimize the risk of cross‐infection and ensure the stoma site is thoroughly cleaned (Healey et al. [66], R; Loveday et al. [91], R).
3. 5.Show
   Use low‐linting gauze to dry the area thoroughly.
   To ensure the stoma site is thoroughly dry (NNNG [127], R).
4. 6.Show
   Secure the jejunostomy tube to the skin with hypoallergenic tape. The site may be covered with a dry dressing or left uncovered.
   To prevent the weight of the tube pulling on the exit site. E

Post‐procedure

1. 7.Show
   Remove and dispose of any equipment.
   To reduce the risk of cross‐infection. E
2. 8.Show
   Record the procedure in the patient's notes.
   To maintain accurate records (NMC [126], C).