Failure to Follow Feeding Tube Medication Administration Protocol
Penalty
Summary
A deficiency occurred when a registered nurse administered enteral medications through a feeding tube to a resident who was able to take medications orally, without verifying tube placement prior to administration as required by facility policy. The nurse prepared the medications by crushing them, mixing with water, and using a syringe to push each medication swiftly through the tube, followed by water, without checking for residual or proper tube placement beforehand. During the process, the resident coughed and an orange-like substance was expelled from the tube, prompting the resident to clamp the tube. The nurse later attempted to flush the tube with water and checked lung sounds only after medication administration was completed. Additionally, medication residue was observed left in the medication cup and on the syringe, indicating incomplete administration. The resident involved had diagnoses of anemia, cancer, and malnutrition, and was cognitively intact according to the MDS assessment. Staff interviews confirmed that medications should not be pushed quickly through the tube and that tube placement must be checked prior to administration. The facility's policy required verification of tube placement before administering feedings or medications, which was not followed in this instance. The Director of Nursing acknowledged that the nurse should not have administered medications via the tube when the resident could take them orally, should not have pushed medications swiftly, and should have ensured all medication was administered without leaving residue.