Failure to Follow Enteral Feeding Orders and Labeling Policy for Tube-Fed Resident
Penalty
Summary
The deficiency involves the facility’s failure to provide appropriate care and services for a resident receiving tube feedings in accordance with facility policy and physician orders. Facility policy for enteral tube feeding via continuous pump required staff to document initials, date, and time on the formula label when the formula was hung and to verify the label against the order. The resident had diagnoses including diabetes and hemiplegia. On two separate observations, the resident’s feeding pump was found idle and inactive for at least 10 minutes, and the bottle of Glucerna and tubing at the bedside were not labeled with the date or time they were opened and hung, contrary to the facility’s policy. Review of the resident’s February MAR showed an order for Glucerna 1.5 as gravity/bolus enteral feedings every four hours, with specified volumes at each administration time. The MAR further showed that the resident received 0 ml of Glucerna 1.5 at two scheduled administration times. During interviews, the DON stated there was an equipment issue and that the facility did not have the correct pumps to administer the ordered Glucerna 1.5, and also acknowledged that she would expect the resident’s tube feed to be labeled and dated per facility policy. These findings demonstrate that the facility did not follow its own enteral feeding policy and did not ensure ordered tube feedings were administered as prescribed for this resident.
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