Failure to Follow Physician Orders for Tube Feeding
Penalty
Summary
A deficiency occurred when a physician's order for a resident receiving tube feedings was not followed. The medical record indicated that the resident required residual checks prior to each tube feeding, with specific instructions to hold the feed and recheck if residuals exceeded 200ml, and to notify the physician if residuals were greater than 500ml. Additionally, the order required verification of tube placement before medication administration or feeding. During an observation, an LPN administered a tube feeding without checking the residual as ordered. When interviewed, the LPN stated she was unaware of the order to check residuals prior to feeding and explained her practice of waiting longer after breakfast to avoid the resident becoming too full. The administrator confirmed that the physician's orders should have been followed.