Failure to Properly Change and Date Enteral Feeding Equipment
Penalty
Summary
Surveyors found that the facility failed to adhere to professional standards of practice regarding the changing and dating of enteral feeding equipment for five out of eight residents reviewed for tube feeding. Observations revealed that several residents had enteral feeding bags and water flush bags that were either undated or outdated. For example, one resident's water flush bag was dated two days prior to the observation, and several other residents had undated water bags or feeding bags. Photographic evidence was obtained to document these findings. Medical records confirmed that these residents had physician orders for specific enteral feeding regimens and water flushes, but the required dating and timely changing of equipment was not consistently performed. Interviews with facility staff, including an LPN, RN, and the DON, indicated that the night shift was responsible for changing out all tube feedings, bags, and syringes, and that these items should be dated when placed. However, the presence of undated or outdated equipment during the survey indicated that this protocol was not being reliably followed. The residents involved had complex medical histories, including conditions such as hemiplegia, gastrostomy status, amyotrophic lateral sclerosis, and severe malnutrition, making adherence to enteral feeding protocols especially important.