Failure to Follow Physician's Orders for Enteral Tube Flushing
Penalty
Summary
A deficiency occurred when a licensed vocational nurse (LVN) failed to follow physician's orders regarding the flushing of an enteral feeding tube for a resident with significant medical needs. The resident, a male with diagnoses including pneumonitis due to inhalation of food and vomit, acute respiratory failure with hypoxia, gastroparesis, and gastrostomy status, was severely cognitively impaired and dependent on an enteral feeding tube for nutrition and medication administration. According to the physician's orders, the feeding tube was to be flushed with 30 ml of water before and after medication administration, and 10 ml between medications. During a medication pass, the LVN only flushed the tube with 10 ml of water prior to administering medications and 15 ml after, instead of the prescribed 30 ml. The LVN acknowledged forgetting to follow the correct flush amounts as ordered. The facility's policy and the Director of Nursing both confirmed the importance of adhering to the prescribed flush volumes to prevent tube clogging and ensure proper medication administration. The failure to follow the physician's orders constituted a deficiency in providing appropriate care for a resident with an enteral feeding tube.