Failure to Properly Verify G-Tube Placement Prior to Feeding
Penalty
Summary
A deficiency occurred when a resident receiving nutrition and medication via a G-tube did not receive appropriate treatment and services as required by facility policy and the resident's care plan. The facility's policy and the resident's care plan both required that tube placement be verified before each feeding and medication administration by both auscultation and aspiration of gastric contents. However, during observation, a registered nurse checked the G-tube placement using only air and did not aspirate gastric contents prior to administering the tube feeding. The nurse acknowledged in an interview that she typically does not aspirate gastric contents, despite knowing it is required. Further interviews with the nursing supervisor and the director of nursing confirmed that their expectation is for staff to both listen for air flow and aspirate gastric contents when checking G-tube placement. The resident involved had significant cognitive impairment, severe protein-calorie malnutrition, and was at risk for complications related to tube feeding. The failure to follow established protocols for verifying tube placement and aspirating gastric contents prior to feeding constituted a deficiency in care for this resident.