Failure to Administer Enteral Feeding as Ordered
Penalty
Summary
A deficiency occurred when a resident with a history of traumatic subarachnoid hemorrhage and gastrostomy status did not receive the prescribed amount of enteral nutrition as ordered by the physician. The physician's order specified that the resident should receive Jevity 1.5 at 75 ml/hour for 20 hours daily, with the feeding paused from 8:00 a.m. to 12:00 p.m. However, observation revealed that the resident was receiving tube feeding at a rate of 60 ml/hour continuously over 24 hours, and the feeding was not stopped during the specified time frame. The nurse responsible for the resident was unaware of the correct order and believed the feeding was to be administered at 60 ml/hour without interruption. Interviews with facility staff, including the LVN, Registered Dietician, and DON, confirmed that the prescribed enteral feeding orders were not followed. The LVN admitted to not knowing the correct rate or schedule and only replaced the formula bottle when it was nearly empty. The Registered Dietician and DON both stated that the resident was at risk for inadequate nutrition due to not receiving the recommended amount of enteral feeding. Review of facility policy indicated that enteral feeding should be administered as ordered by the physician, with careful calculation and verification of the amount to be given per shift.