Agency for Clinical Innovation. ACI Nutrition Network Guidelines for Home Enteral Nutrition (HEN) Services. 2nd edn. A clinician's guide. Caring for people with gastrostomy tubes and devices. From pre insertion to ongoing care and removal. 2015. https://tinyurl.com/yy4ek4ge (accessed 19 June 2019) Show Care Quality Commission. Administering medicines safely via enteral feeding tubes. 2018. https://tinyurl.com/y6l73avr (accessed 19 June 2019) National Patient Safety Agency. Patient Safety Alert 05. Reducing the harm caused by misplaced nasogastric feeding tubes. 2005. http://tinyurl.com/y9o85cts (accessed 12 June 2019) Rapid response report NPSA/2012/RRR001. Harm from flushing nasogastric tubes before confirmation of placement.London: NPSA; 2012 NHS Improvement. Patient safety alert. Nasogastric tube misplacement: continuing risk of death and severe harm. 2016. https://tinyurl.com/ybr576l6 (accessed 21 June 2019) Simons S, Remington R. The percutaneous endoscopic gastrostomy tube: a nurses guide to PEG tubes. Medsurg Nursing. 2013; 22:(2)77-83 Is your feeding tube clogged? Maintenance of gastrostomy and gastrojejunostomy tubes. 2016. https://tinyurl.com/y5vec2ct (accessed 19 June 2019) About Tube FeedingIf you cannot eat sufficient quantities of food to meet nutritional needs, then feeding can be given through a tube into the stomach or small bowel to provide adequate nutrients. There are a variety of tube feeding formulas on the market which are designed to meet 100% of your nutritional needs. The feedings may be given continuously over several hours, around the clock at a specific rate, and delivered by a special pump or several times a day in measured amounts. Adequate nutrition depends on the right type and amount of formula. Your healthcare provider will prescribe your feeding schedule, formula and amount of water needed for optimal nutrition and hydration. After a brain or spinal cord injury, the metabolic rate may be increased and energy and protein needs may be high to provide nutrients for healing. Muscle atrophy is also common because of decreased mobility during this time. Calorie and protein needs tend to decrease a few months after injury, so tube feedings may need to be adjusted to avoid unwanted weight gain. It is important to monitor your body weight and know your weight goals. If you have significant weight changes (gain or loss of more than 2 lbs in 1 week) or if you are cleared to eat by a Speech Language Pathologist, contact your doctor, home health company, or registered dietitian for a tube feeding adjustment. Types of Feeding Tubes
You may see an adapter such as the Dale Ace connector Tube Feeding Preparation
Supplies to Gather:
Positions for receiving tube feedings:
How to check gastric residual (PEG feedings only):"Residual" refers to fluid/contents that remain in the stomach. Only those fed through a PEG tube should have a residual.
Note: If using a PEG, it is important to check tube feeding residuals every 4 hours while receiving continuous feedings and right before bolus feedings. Cleaning the Tube Site and Equipment
Mouth Care:
Troubleshooting Feeding TubesRecognition:
Causes:
Prevention:
What do I do when I have a clogged tube?
Recognition:
Causes: 1. Mechanical problem
2. GI problems
3. Side effect of medication or other treatments 4. Problem with formula
5. Offensive odors, sight and smell of food Prevention:
Immediate Action:
Recognition:
Causes:
Prevention:
Immediate Action:
Recognition:
Causes:
Prevention:
Immediate Action:
Recognition:
Causes:
Prevention:
Immediate Action:
Call your physician if any of the following occurs:
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