Policy Manual sample

MDT Home Health Care Agency, Inc. 46 FEEDING-ENTERIC PURPOSE: Enteric feeding is completed to meet nutrition and hydration requirements by delivery through nasogastric, gastric or intestinal routes. All care will be provided in accordance with physician's orders which specify the amount and type of feeding as well as the rate. When the patient is on bolus feedings, tube placement will be verified prior to each feeding. When the patient is on continuous feedings, family or caregivers will be taught to assess placement and residuals per physician’s orders. Continuous feedings should be administered with a pump and the formula should not hang longer than 24 hours. When feedings are administered via G-tube, the stoma site should be inspected for signs and symptoms of redness, drainage and leaking. When pumps are used, manufacturer's guidelines will be followed. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: • Feeding pump set • Compatible syringe • Feeding pump as ordered • Prescribed enterals • Flush solution (usually water) • Nonsterile gloves • IV Pole or hook SPECIAL CONSIDERATIONS: 1. Selection of a formula is made by the physician and is based on the area of the GI tract to which it will be delivered. 2. Commercially prepared solutions differ in caloric and nutritional content. Selection is made based on individual need and tolerance. 3. Feedings may be given by bolus ingestion or by continuous drip. 4. Bolus ingestion more closely resembles normal dietary patterns. 5. Continuous drip infusions may reduce diarrhea and increase absorption. 6. Continuous feedings with drip-rate should be administered with a pump. 7. Physician will order formula and rate to be administered by pump. 8.. The force of gravity alone will not permit infusion of feeding material through small bore tubes. A pump is necessary. 9. Do not hang formula longer than 24 hours. 10. Irrigate feeding tube with 30-60cc water after medication administration. 11. Teach family patient also will require 6-8 glasses of water every day or per physician’s orders to maintain adequate hydration.