HospitalInspections.org

Based on hospital policy and procedure review, medical record review, and staff interviews, the nursing staff failed to ensure the hospital's policy regarding changing of the nasogastric tube (NG tube) policy was followed for 1 of 2 sampled patient records reviewed (#7).

The findings included:

Review on 10/16/2018 of the hospital policy title "Gastric Tubes: Feeding and Decompression" revised June, 2018 revealed "Feeding: Intermittent, Bolus or Continuous ...6. ...Change NG and OG (orogastric) tubes every 30 days ..."

Review on 10/16/2018 of the closed medical record for Patient #7 revealed a 13-year-old female admitted on 07/17/2018 with a diagnosis of Failure to Thrive/rule out Eating Disorder. Review of the physician order revealed an order dated 07/18/2018 at 1841 for insertion of an NG tube. Review revealed a physician order dated 08/27/2018 at 1622 to discontinue the NG tube. Review of the NG tube daily assessment Flowsheet from 07/18/2018 through 08/27/2018 revealed a 10 Fr (French) NG tube was placed on 07/18/2018 at 1900 to the right nostril and the NG tube was removed on 08/27/2018 at 1631 as ordered. Review revealed the NG tube was in place for a total of forty-one (41) days. Review of the medical record review revealed evidence that the nursing staff failed to follow the facility policy to change the NG tube every thirty (30) days.

Interview on 10/16/2018 at 1400 with Registered Nurse (RN) #1 revealed RNs may insert NG tube with a physician order. Interview revealed if an NG tube was patent it may be kept for up to 30 days.

Interview on 10/17/2018 at 1340 with the Unit Manager revealed the nursing staff were expected to obtain a physician order and to change the NG tube every 30 days as per the policy. Interview confirmed the nursing staff failed to follow the hospital policy for changing the NG tube after 30 days.