Failure to Maintain Proper Head Elevation During Tube Feeding
Penalty
Summary
A deficiency occurred when a resident with a gastrostomy tube (GT) was observed receiving continuous tube feeding while lying in a Geri-chair with the head of the chair elevated to only about 10 degrees. Facility policy and the resident's physician order required the head of the bed or chair to be elevated 30 to 45 degrees during GT feedings to observe aspiration precautions. The Licensed Vocational Nurse present confirmed that the resident was not in the correct position and acknowledged that the head of the Geri-chair should have been elevated as per the order and policy. The resident involved had multiple diagnoses, including anemia, GT placement, and chronic obstructive pulmonary disease (COPD), and was assessed as having severely impaired cognitive skills, being totally dependent on staff for care. The failure to maintain the required elevation during tube feeding was directly observed by surveyors and confirmed by staff, representing a lack of adherence to professional standards of practice and the facility's own policy for enteral feeding safety.