Failure to Check Gastric Residual Prior to G-Tube Feeding
Penalty
Summary
A deficiency occurred when a nurse failed to check a resident's gastric residual prior to administering enteral nutrition via a gastrostomy tube (G-tube), as required by the resident's physician order. The facility's policy on enteral nutrition specifies that the physician prescribes the formula, rate, route, and flush orders for each resident. The resident in question had a physician order dated 4/9/2025 to check for gastric residual before feeding, with instructions to hold feeding and notify the physician if the residual exceeded 100 mL. During observation, the LPN initiated the G-tube feeding by flushing the tube and starting the nutritional supplement without checking the gastric residual. The LPN later confirmed in an interview that the gastric residual was not checked as ordered. A registered nurse described the correct procedure for checking gastric residual, which was not followed in this instance. The resident was assessed as having a feeding tube and received more than half of her calories via tube feeding during the assessment period.