Failure to Properly Verify Gastrostomy Tube Placement
Penalty
Summary
The facility failed to properly check the placement of a resident's gastrostomy tube (GT) as required by the resident's care plan and physician orders. Specifically, nursing staff used the method of injecting air into the GT and auscultating the abdomen to confirm placement, rather than aspirating gastric contents as directed. This practice was observed on multiple occasions, and staff confirmed they had been trained to use this outdated method. The resident's care plan and physician orders both specified that tube placement and gastric contents should be checked prior to feeding and medication administration. Additionally, the facility's policy on enteral feeding, last revised in 2013, had not been updated to reflect current standards of practice.