Failure to Follow Enteral Hydration Orders for NPO Resident
Penalty
Summary
A deficiency occurred when the facility failed to follow physician orders for enteral fluid hydration for a resident who was entirely dependent on enteral intake due to being NPO. During an observation of a scheduled enteral feeding, a nurse administered only 120cc of water before and after the feeding, instead of the ordered 240cc of water every 6 hours for hydration. The nurse combined the hydration order with the feeding schedule, resulting in the resident receiving less water than prescribed. Upon interview, the nurse acknowledged awareness of the hydration order and admitted to not administering the full prescribed volume, leading to the resident missing 120cc of water per feeding. The resident's medical record confirmed orders for Jevity 1.5 via PEG tube five times a day, with specific instructions for water flushes both for hydration and before and after feedings. The nurse recognized the importance of following these orders, as the resident's hydration needs were calculated by the Registered Dietitian.