Untrained CNAs Adjusted Feeding Pump Against Policy
Penalty
Summary
The facility failed to ensure that residents receiving enteral nutrition via feeding tubes were provided with appropriate care and that only trained and authorized staff handled feeding pumps. In one instance, a certified nurse aide (CNA) who was not properly trained and not permitted by facility policy adjusted a resident's feeding pump while providing incontinent care. The resident in question was a female with severe cognitive impairment, total dependence for toileting and personal hygiene, and a history of dysphagia requiring tube feeding. During care, the resident's head was lowered and the feeding machine was placed on hold, after which the CNA restarted the feeding pump without a nurse present. Interviews with CNAs and nursing staff revealed that CNAs were not supposed to pause, stop, or restart feeding pumps, as this was outside their scope of practice and not included in their job description. Both CNAs involved admitted to not being properly trained on feeding pumps, and the Director of Nursing confirmed that only licensed nurses were authorized to handle feeding machines. The facility's policy and job descriptions did not support CNAs performing these tasks, and there was no documentation of training for CNAs on feeding pump operation.