Name of the Procedure:

Enteral Feeding Supply Kit; Gravity Fed
Common names: Gravity Fed Enteral Feeding Kit
Technical/medical term: HCPCS Procedure B4036

Summary

This procedure involves the use of a gravity-fed enteral feeding supply kit, which includes necessary items such as a feeding/flushing syringe, administration set tubing, dressings, and tape, providing daily nutritional support to patients who are unable to ingest food orally.

Purpose

The procedure aims to provide essential nutrients directly into the gastrointestinal tract for patients who cannot eat by themselves due to various medical conditions. The ultimate goal is to ensure adequate nutritional intake, maintain or improve health status, and prevent malnutrition.

Indications

• Patients with difficulty swallowing due to neurological disorders (e.g., stroke, ALS).
• Conditions causing obstruction of the esophagus.
• Severe anorexia or other eating disorders.
• Critical illnesses where oral intake is not feasible.
• Postoperative support in gastrointestinal surgeries.

Preparation

• Patients should be instructed to avoid oral intake of food or drink as per doctor's guidance.
• Review of current medications and possible adjustments.
• Basic assessments like checking for previous allergies to materials used.
• Ensuring the feeding tube is properly placed and patent.

Procedure Description

1. Verify the patient's identity and explain the procedure.
2. Gather all necessary supplies: feeding/flushing syringe, administration set tubing, dressings, and tape.
3. Use aseptic technique to prepare all components.
4. Attach the administration set tubing to the feeding tube.
5. Pour the prescribed feeding solution into the feeding bag.
6. Prime the tubing to remove air.
7. Connect the feeding bag to the administration set tubing.
8. Adjust the flow regulator to control the feeding rate as per the prescription.
9. Secure the feeding tube with dressings and tape.
10. Flush the tube with water if needed, using the feeding/flushing syringe.

Duration

The actual setup of the feeding kit typically takes around 15-30 minutes. Feeding time can vary depending on the patient's needs and prescribed feeding rate.

Setting

The procedure can be performed in various settings including hospitals, outpatient clinics, long-term care facilities, or even at home under a healthcare provider's supervision.

Personnel

• Registered Nurse (RN) or Licensed Practical Nurse (LPN)
• Dietitian (for nutritional guidance)
• Physician (for prescribing and initial setup)
• Caregivers (for ongoing daily management at home)

Risks and Complications

• Infection at the feeding tube site.
• Dislodgment or blockage of the feeding tube.
• Aspiration pneumonia if contents are regurgitated.
• Gastrointestinal discomfort, such as bloating or diarrhea.

Benefits

• Provides essential nutrition to patients who cannot eat orally.
• Helps maintain or improve health status and prevent malnutrition.
• Generally, benefits are realized shortly after initiation, optimizing the patient's nutritional status.

Recovery

• Ensure proper hygiene and care of the feeding site.
• Monitor for signs of complications such as infection.
• Follow a balanced and appropriate feeding regimen as directed by a healthcare provider.
• Regular follow-up appointments to adjust feeding protocols as necessary.

Alternatives

• Oral feeding, if feasible with adaptive techniques.
• Parenteral nutrition (intravenous feeding) for patients with severe gastrointestinal issues.
• Nasogastric or nasojejunal feeding as a temporary alternative.

Pros and cons:

• Oral feeding is more natural but may not be possible.
• Parenteral nutrition bypasses the gut but can have more risks like infection and metabolic complications.
• Nasogastric feeding is less invasive but can be uncomfortable and temporary.

Patient Experience

Patients might experience a sense of dependency initially; however, with proper training and support, they typically adapt to the routine. Minimal pain is expected if aseptic techniques are properly followed, and comfort measures such as securing the tube well can prevent irritation or discomfort. Pain management is usually not required beyond routine care.