Improper Administration of Enteral Medications via Feeding Tube
Penalty
Summary
Staff failed to follow facility policy and procedures regarding the administration of medications via a feeding tube for a resident with a PEG tube. The resident, who was cognitively intact as indicated by a BIMS score of 15, required tube feeding and received medications through the enteral tube. During observation, a registered nurse used a piston syringe to slowly push medications and water into the resident's enteral tube, rather than administering them by gravity as outlined in the facility's policy. The nurse stated that medications were not given by gravity due to resistance in the tube, and that the resident preferred a light push during administration. The Director of Nursing confirmed that the facility's policy did not specify that pushing medications was acceptable practice and acknowledged that this method was not included in the resident's care plan. The policy reviewed indicated that medications should be administered slowly and steadily, with the flow rate determined by the elevation of the syringe, not by pushing. The deviation from policy and lack of care plan documentation for the resident's preferred method led to the deficiency.