Failure to Secure and Cover Feeding Tube Tip After Disconnection
Penalty
Summary
A deficiency occurred when staff failed to secure and cover the feeding tube tip with a cap after disconnecting it from a resident who was receiving enteral feeding. During an observation, the disconnected feeding tube tip was found lying on the floor, uncovered and exposed to the environment. The registered nurse present confirmed that the tube should have been covered with a cap and secured on the pump when not in use, in accordance with facility policy and best practices to prevent infection. The resident involved had a history of gastrostomy, dysphagia, tracheostomy, and traumatic brain injury, and was assessed as having severely impaired cognitive functioning, requiring total assistance with all activities of daily living. The care plan identified risks including infection at the gastrostomy tube site, and the physician's orders specified the use of tube feeding. Facility policy required that enteral feeding safety precautions be followed, including keeping the tube covered when not in use, but this was not done in this instance.