Improper Administration of G-Tube Flushes Not Performed by Gravity
Penalty
Summary
The deficiency involves the administration of G-tube flushes not being performed by gravity as required for a resident receiving enteral medications. During a medication pass, an LPN prepared a crushed pill for a resident with a gastrostomy tube, entered the room, performed hand hygiene, donned a gown and gloves, placed the tube feeding on hold, and checked for residual. She then drew up 30 cc of tap water into a syringe, opened the G-tube, inserted the syringe directly into the tube, and pushed the 30 cc of water into the tube using the plunger instead of allowing it to flow by gravity. The same nurse then diluted the medication in 30 cc of water and administered the medication and remaining flush by gravity. In a subsequent interview, the LPN acknowledged that she had not administered the initial G-tube flush by gravity and stated that while she always administered medications by gravity, she sometimes pushed flushes in and was unsure of the facility’s policy. The DON was informed that the G-tube flush had not been administered by gravity and stated that the facility’s policy did not specify that flushes must be given by gravity. The facility’s written policy addressed flushing the feeding tube with 30 cc of water or as ordered after verifying placement and residual, and an external article from Ohio State University Medical Center specified that water should be allowed to flow into the feeding tube by gravity when flushing.
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