Failure to Follow Enteral Feeding Protocols
Penalty
Summary
A deficiency was identified when a nurse failed to follow established facility policy and physician orders during the administration of enteral tube feeding for a resident. The facility's policy required that the head of the bed be elevated to at least 30 degrees during feedings and that gastric residuals be checked prior to starting the feeding. The physician's orders also specified the need to elevate the head of the bed to 30-45 degrees during tube feedings and to administer a specific enteral formula at a set rate. During observation, the nurse was seen setting up and administering the tube feeding without checking for gastric residuals and without ensuring the resident's head of the bed was properly elevated. The head of the bed was measured at 20 degrees, below the required minimum. The nurse confirmed that she did not check for gastric residuals and incorrectly stated that the bed was elevated to 30 degrees. These actions were inconsistent with both facility policy and physician orders.