Improper Flushing Technique Used for Enteral Feeding Tube
Penalty
Summary
A deficiency occurred when a registered nurse (RN) flushed a resident's gastrostomy tube with 250 ml of water by pushing the water into the syringe barrel with a plunger, rather than allowing the water to flow by gravity. This action was observed during a medication administration for a female resident with severe cognitive impairment, a history of cerebrovascular accident, chronic obstructive pulmonary disease, type 2 diabetes mellitus, hemiplegia, cerebral infarction, and hypertension. The resident's care plan specified tube feeding and required monitoring for complications such as aspiration, fever, tube dislodgement, and infection at the tube site. The RN acknowledged using the plunger to flush the tube and stated she believed it was acceptable because there was no residual, but typically used gravity for medication administration. The facility's Director of Nursing confirmed that facility policy requires gravity to be used for flushing gastrostomy tubes, with gentle plunger pressure only if gravity cannot be used due to blockage. The facility's policy explicitly states not to force fluids into the tube and to allow gravity to work, applying gentle pressure only if necessary after repositioning the resident.