Failure to Maintain Proper Head of Bed Elevation During G-Tube Feeding
Penalty
Summary
A deficiency occurred when a resident receiving gastrostomy tube (G-tube) feeding was observed lying in bed with the head of bed (HOB) at a 20-degree angle, which was below the required 30-45 degree elevation specified in the facility's policy and the resident's care plan. The assigned LVN confirmed that the HOB was lower than the required angle during the feeding. The resident was receiving Glucerna 1.2 at 60 cc per hour via G-tube at the time of observation. The resident had a medical history including chronic obstructive pulmonary disease (COPD), hemiplegia and hemiparesis following a stroke, and aphasia. The care plan and physician orders both specified that the HOB should be elevated at least 30-45 degrees during and for at least one hour after tube feeding to reduce the risk of complications. The facility's policy also required staff to be trained and competent in enteral feeding safety precautions, including maintaining proper HOB elevation. Despite these requirements, the resident was not positioned as directed during the feeding.