Gavage Feeding

Continuous Gavage Feeding

   1. Perform hand hygiene and apply clean gloves.
   2. Verify the patient's identity using two patient identifiers in accordance with institutional policy.
   3. Verify the position of the OG or NG tube.
   4. Position the infant prone or right side-lying with the head of the bed elevated to approximately 30 degrees.
   5. To administer the prescribed oral medications, add them to a small amount of formula and administer them at the beginning of the feeding. Verify patient identity using two patient identifiers in accordance with institutional policy before administering any medication.
   6. Connect the enteral tubing, if required, to the infant's OG/NG tube.
   7. Place the syringe on the pump and program it to deliver the prescribed amount of EBM or formula over 3 to 4 hours or as ordered. Start the pump.
   8. Offer a pacifier to the infant if appropriate.
   9. Remove gloves and discard in proper trash receptacle. Perform hand hygiene.
  10. While the feeding is infusing, monitor the infant for any signs of distress. Stop the feeding if cyanosis, coughing, or other signs of distress appear. Recheck the tube placement and notify the physician as necessary.
  11. Document the procedure in the patient's record.

Intermittent Gavage Feeding

   1. Repeat steps 1 through 6 of Continuous Gavage Feeding.
   2. Place the syringe in the pump and program it to deliver the ordered volume of feeding.
   3. Offer a pacifier to the infant if appropriate.
   4. Alternatively, the nurse may gravity feed the desired amount by holding the syringe slightly above the infant's head and removing the plunger, allowing the feed to slowly run in at a rate of approximately 1 to 3 ml/min. The family may also participate in gravity feeding as allowed by institutional policy.
   5. While the feeding is infusing, monitor the infant for any signs of distress. Stop the feeding if cyanosis, coughing, or other signs of distress appear. Recheck the tube placement and notify the physician as necessary.
   6. When the feeding is complete, disconnect the enteral tubing and flush the OG/NG tube with an air bolus or sterile water as per institutional policy. Cap the OG/NG tube.
   7. Leave the infant in the side-lying or prone position for at least 30 minutes after the feeding is complete.
   8. Remove gloves and discard in proper trash receptacle. Perform hand hygiene.
   9. Document the procedure in the patient's record.
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