We get many questions from our aged care homes on how to prepare for a new resident with a tube feed. So, we’ve come up with a check list of all the things that need to be considered, for a smooth admission for your home and your resident.
First step is to get all the background information
The Type of Tube
Is it a PEG, PEJ, NG?
Most tubes that come into aged care homes are PEG or gastrostomy tubes (meaning they are placed to allow feed to go directly into the stomach). However, sometimes Nasogastric tubes or PEJ tubes (PEG tube with a jejunal extension) are in place. These tubes require some different care which should be highlighted to staff. For example, PEJ tubes should not be rotated. NG tubes require the position to be checked frequently as they are more prone to becoming dislodged.
Feed brand and product
Make sure the feed and feeding supplies can be obtained in a timely manner, so contact your supplier. If the feed is not available? from your preferential company, you may not be able to order immediately, and your supplier may take longer to get the feed. If you have preferential agreement with a feed company, contact the hospital dietitian to determine if the feed is a specific choice or simply the hospital preferred product. It may be possible to change the feed if it is a standard product.
Ensure the hospital will provide enough feed to fill the time between discharge and when the home’s order can be received. Ask for extra days if needed as hospital discharge supplies may vary between 3 – 7 days.
Pump, bolus or gravity?
Feeding Regimen and Flushes
How much feed is provided, what times and what rate? How much water is required and when is it given?
Giving sets for a pump or for gravity feeds (consider if needed with medication ports)
Do you need EnFit adaptors?
To reduce the risk of feed and IV mix ups, feeding is being transitioned to Enfit ends. Whilst Plastics (giving sets and syringes for feeding) are fitted with Enfit, there are still a mix of feed tubes being placed. If the tube (e.g. PEG) has an Enfit connector, all will be compatible. Although, if it’s an older style you may need to have some Enfit connectors on order. These should stay in the tube and not be removed or discarded after feeds.
Syringes (for bolus feeds and water flushes)
Consider the types and sizes you need. Do you have enough available?
Nil by Mouth or Eating
If a resident is eating, what type of diet are they on and how much are they eating?
Get the assistance you need
There are a number of great resources available so get these people involved. These include:
- Local hospital dietitian
- Community or Aged Care dietitian
- Stoma Care teams
- In Reach Services
- General Practitioners
- Supplier representatives and nurses
- Nurses with enteral feeding experience
- Pump representatives
If you have questions or your staff need some upskilling, plan it early.
Confirm all your supplies are in hand, staff are ready and confident to receive your new resident. Remember to update the care plan with all the feeds, flushes and tube care schedules. Discuss with your dietitian and manager regarding possible rebates or funding for the feeds and giving sets.
If you would like more information please contact Leading Nutrition on 1300 722 712 or via the contact form below.