Scope

  • Policy Statement

  • The Policy
  • Responsibilities of the Staff
  • Responsibilities of the Organisation
  • Related Policies
  • Related Guidance
  • Training Statement

Policy Statement

This organisation believes that the best way to ensure this state of safety exists is to have robust policies and procedures in place, to ensure that staff are well trained and competant to manage the nutritional and hydration needs of the service user enterally.

The Policy

This policy is intended to set out the values, principles and policies underpinning this organisation’s approach to enteral management. The organisation aims to ensure that, as far as is possible, staff are trained and know exactly their role is and how to react to any changes. This policy meets the Fundamental Stanards of Care as defined by the Care Quality Commission (2018) and inspected under the Key Line of Enquiry ‘Safe’. It also meets guielines set out in the National Institute for Clinical Excellence (2017). Some sections also relate to legislation set out in the Mental Capacity Act (2005).
This policy applies to all Sphere Specialist Healthcare staff including volunteers and covers all Service Users who have a feeding tube in-situ.

The goals of the organisation are:

  • Enable the Service User to remain as independent as possible but to receive assistance where necessary.
  • Provide a safe framework for the Service User and staff by ensuring only competent and trained staff are utilised to provide effective care and management of their enteral needs and ensure that the Service User remains free from infection and healthy at all times.
  • Ensure that all staff are aware of and follow this organisations policies and procedures at all times

Responsibilities of the Staff

Support Workers must ensure:

  • They are aware of and comply with Sphere Specialist Healthcare polices and procedures at all times.
  • They are aware of type of feeding tube their client has in-situ and their feeding regime.
  • Consumerables are cleaned and replaced as per support plan.
  • The stoma site is kept clean, dry and free from infection. Staff must be aware of the signs and symptoms of infection and escalate as appropriate and documented in the daily records and body map completed if necessary.
  • All enteral care including changes of the device and/or concerns must be documented in the daily records and reported to the office.
  • The Medication Administration Record is completed for all medication administered including feeds. Any discrepancies or changes should be reported to the office and documented.
  • All fluids given enterally including feeds and flushes given with medication must be recorded on the Fluid Balance Chart along with any fluids consumed orally.
  • In the event of a blocked or dislodged device they inform the office and District Nurses or Nutritional Nurse specialist and this must be documented in the daily records.
  • They are aware of the signs and symptoms of infection. All action should be docmented and the office informed at the earliest opportunity.
  • They inform the office if they do not feel competent or confident to care for clients with enteral needs.

Responsibilities of the Organisation

  • On receipt of a new or amended package which includes enteral care, the Case Manager should identify any staff that require the relevant training and inform the Registered Manager.
  • The Case Manager must update the support plan to document the need for enteral care and this should be signed off by a Registered Nurse as this is a delegated nursing task.
  • The Case Manager should obtain an up-to-date feeding regime and prescription for the client.
  • Arrange comprehensive Enteral Care training, this will be face to face and in-house. Training will include basic knowledge of the anatomy and physiology of the gastri-intestinal system, an awareness of the different types of feeding tubes and the factors by which these were chosen and possible complications which could arise and how to manage.
  • Competencies of the staff will be assessed by one of the organisations nurses.

Related Policies

  • Sphere Specialist Healthcare Consent Policy
  • Sphere Specialist Healthcare Infection Control Policy
  • Sphere Specialist Healthcare Nutrition and Hydration and Food Safety Policy
  • Sphere Specialist Healthcare Record Keeping Policy
  • Sphere Specialist Healthcare Oral Health Policy
  • Sphere Specialist Healthcare Medication Policy

Related Standard Operating Procedures

  • SOP Enteral 1 Care of the Gastrostomy (PEG)
  • SOP Enteral 2 Care of the Jejunostomy (PEJ)
  • SOP Enteral 3 Care of the Naso-gastric Tube
  • SOP Enteral 4 Changing water in water retained device
  • SOP Enteral 5 Admistration of medication via Gastrostomy and Jeunostomy Tubes

Related Guidance

Fundamental Standards of Care. Care Quality Commission (2018)
NICE Guidelines (2017)
Mental Capacity Act (2005)
British Association for Parenteral and Enteral Nutrition (BAPEN)
https://www.bapen.org.uk/nutrition-support/enteral-nutrition/medications

Training Statement

All staff, during induction, are made aware of the organisation’s policies and procedures, all of which are used for training updates. All policies and procedures are reviewed and amended where necessary, and staff are made aware of any changes. Observations are undertaken to check skills and competencies. Various methods of training are used, including one to one, online, workbook, group meetings, and individual supervisions. External courses are sourced as required.

Date Reviewed: November 2021
Person responsible for updating this policy: Carly Fortune
Next Review Date: November 2022