The intent of of the regulation is that:
- The feeding tube is utilized only after adequate assessment determines that the resident's clinical condition makes this intervention medically necessary;
- A feeding tube is utilized in accordance with current clinical standards of practice and services are provided to prevent complications to the extent possible; and
- Services are provided to restore normal eating skills to the extent possible.
The facility must have "protocols regarding feeding tube nutrition and care... and "be developed with the medical director in order to assure staff implement and provide care and services according to resident needs and clinical standards of practice".
What will surveyors be looking for? Some of the areas that may specifically be reviewed include:
Observations:
Staff attention to psychosocial needs, infection control, mouth care, and accuracy of feeding administration.
Interviews: Staff, residents, and responsible parties on the care and meeting nutritional needs, and identifying how staff are trained in managing feeding tubes.
Record Review: Has the resident had periodic reassessment of the appropriateness or necessity of the tube feeding? Have staff identified and monitored potential complications with physician notifcation and appropriate interventions for prevention?
QA: Surveyors may also review facility practices to see if tube feeding management and appropriateness is incorporated into quality assurance activities.
Review this enteral feeding worksheet to see if your physician orders for tube feedings are in compliance.
Nutricopia incorporates the most current regulations into its Dietetic Services Policy and Procedure Manual and Diet Manual. Nutricopia Registered Dietitians receive updates and training on changes in regulations and can help you set up your Tube Feeding QA.
Email us for a "tube feeding tune up" visit to assure you are ready for compliance with the new surveyor guidance. Check here for order forms for Nutricopia manuals.
Click here for the advance copy of the surveyor guidance.
