Failure to Administer Physician-Ordered Water Flushes via Feeding Tube
Penalty
Summary
A deficiency occurred when a resident with a history of severe protein-calorie malnutrition, cognitive communication deficit, and dysphagia, who was receiving nutrition and hydration via a feeding tube, did not receive water flushes at the physician-ordered rate. The resident's care plan included providing water as ordered, and the physician's order specified that the feeding tube should be flushed with 200 cc of water every 6 hours, totaling 800 cc per day. During an observation, it was found that the feeding tube pump was set to deliver water flushes at 100 cc every 4 hours, resulting in a total of 600 cc per day, which was less than the prescribed amount. The nurse present acknowledged the discrepancy between the pump settings and the physician's order but could not explain why the settings were incorrect. The DON confirmed that water flushes were expected to be administered at the prescribed rate.