Incorrect Enteral Feeding Formula Administered
Penalty
Summary
The facility failed to ensure that a resident received the correct enteral feeding formula as ordered by the physician. According to the facility's policy, all enteral feedings are to be administered in accordance with verified medical necessity and physician's orders. However, review of the resident's medical record showed an order for Nutren 2.0 at 50 mL per hour, but observation revealed that Isosource 1.5 was being administered at the same rate. The enteral feeding bag was labeled with the start date and time, confirming the incorrect formula was in use. Interviews with the LPN and DON confirmed that the resident had received the wrong enteral feeding formula, and the administrator did not provide any explanation to dispute these findings. The deficiency was identified through observation, interviews, and record review, specifically noting the administration of an incorrect enteral feeding formula to a resident who had a physician's order for a different product.