Improper Flushing Technique Used for Gastrostomy Tube
Penalty
Summary
A deficiency occurred when a nurse flushed a resident's gastrostomy tube by pushing 30 ml of water into the tube using a syringe plunger, rather than allowing the water to flow by gravity. The resident involved was an older male with severe cognitive impairment, dependent on a feeding tube for nutrition, and at risk for aspiration. The resident's care plan specified that tube feedings and flushes should be administered as ordered, with checks for placement and appropriate flushing to maintain hydration and tube patency. The physician's order required flushing the gastrostomy tube with specific amounts of water before and after medications. During observation, the nurse was seen using the plunger method to flush the tube, which was confirmed in an interview with the nurse, who acknowledged the error and stated that gravity should have been used. The Director of Nursing also confirmed that gravity should be used for flushing unless there is a blockage, in which case gentle plunger use may be considered. The facility did not have a policy regarding the use of gravity for tube feeding flushes.