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
   Assist the patient to sit in a semi‐upright position in the bed or chair. Support the patient's head with pillows.
   To allow for access to the gastrostomy. E
3. 3.Show
   Wash hands with soap and water or alcohol‐based handrub, and assemble the equipment required. Apply apron and clean gloves.
   Hands must be cleansed before and after patient contact to minimize the risk of cross‐infection ([115], C).

Procedure

1. 4.Show
   Open the packet containing the different coloured silicone plugs. Select the plug that is the same size or closest in size to the current tube. Attempt to push it into the stoma.
   To assist in keeping the stoma tract patent. E

If the first plug chosen goes in easily

1. 5.Show
   Leave the plug in place and secure with tape over the top.
   To ensure the plug does not slip out. E
2. 6.Show
   Contact the relevant health professional as soon as possible to have a new tube inserted.
   A plug is a temporary measure to maintain the stoma tract. E

If you cannot insert the first plug chosen

1. 7.Show
   Try the next smallest size.
   To ensure that the stoma is filled with the appropriate gauge of plug. E

Post‐procedure

1. 8.Show
   Once the stoma has been successfully plugged, leave the plug in place and secure it with tape to cover the top.
   To prevent movement or the plug falling out. E
2. 9.Show
   Document which plug was inserted.
   To ensure adequate records and to enable continued care of the patient (NMC [126], C).