Improper G-Tube Unclogging Procedure Results in Tube Damage
Penalty
Summary
A deficiency occurred when a licensed nurse failed to follow proper procedures for unclogging a resident's gastrostomy (G-) tube. The resident, who had dysphagia and a G-tube for feeding, experienced a clogged tube as indicated by an alarm on the G-tube pump. The nurse attempted to flush the tube with warm water, which was unsuccessful, and then applied A&D ointment and used a milking technique to try to clear the blockage. During this process, a bubble formed and burst in the tubing, resulting in a tear. The nurse then clamped the tube and notified the RN, who assessed the situation and arranged for the resident to be sent to the hospital for a replacement tube. Interviews with other nursing staff and review of facility policy revealed that the correct procedure for addressing a clogged G-tube is to flush with warm water using a gentle back-and-forth motion, without using force, massaging the tube, or applying ointments. If the clog cannot be cleared, staff are to notify the physician and follow further orders. The nurse's actions deviated from these procedures, as force and inappropriate techniques were used, leading to damage of the G-tube and necessitating hospital transfer for the resident.