Enteral Feeding Support

Enteral feeding means giving nutrition, fluids and sometimes medication directly into the stomach or small bowel through a tube. This lesson explains why a person may need a feeding tube and what it means for their daily life. Key points: common reasons include severe swallowing difficulty, a high risk of aspiration, and being unable to eat or drink enough to stay well; some people have nothing by mouth while others still enjoy some food or tastes as their plan allows; and a feeding tube does not take away a person's right to be included in mealtimes.

There are several kinds of feeding tubes, and each needs slightly different care. This lesson introduces the main types in general terms. Key points: nasogastric tubes pass through the nose into the stomach and are usually short term; gastrostomy tubes, including PEG tubes and balloon gastrostomy tubes or low profile buttons, go through the abdominal wall into the stomach; jejunostomy tubes go into the small bowel and have specific feeding rules; and you must know which type the person has, as the plan and your participant specific training describe.

Enteral feeding and management is one of the high intensity daily personal activities in the NDIS Practice Standards, and the NDIS Commission's High Intensity Support Skills Descriptors set out, in general terms, the knowledge and skills workers need. This lesson explains how that applies to you. Key points: this course builds knowledge only; you must be trained in the participant's plan and assessed as competent by a qualified health practitioner before you support their feeds; you must follow the plan exactly; and you must never change the formula, rate, volume or flushing regime yourself.

Careful preparation prevents many feeding problems. This lesson covers hand hygiene, checking the formula and equipment, and setting up a clean work area. Key points: clean your hands before touching the tube, formula or equipment; check the formula against the plan, including type, volume and expiry date; follow the manufacturer's and plan's instructions on storage and how long a feed can hang; use clean equipment and follow the plan for cleaning or replacing syringes and giving sets; and tell the person what you are doing and seek their consent.

Positioning is one of the most important ways to prevent feed from coming back up and entering the lungs. This lesson explains positioning and the common methods of giving a feed in general terms. Key points: the person should be sitting up or have their head and shoulders raised, often to at least 30 to 45 degrees, during the feed and for the time the plan sets afterwards; feeds may be given by syringe, by gravity or by a pump; flushes are given before and after feeds and medication as the plan directs; and you should watch the person throughout and stop if they show signs of distress.

The stoma is the opening in the skin where a gastrostomy or jejunostomy tube enters the body. Keeping the stoma and tube clean and secure prevents infection, skin damage and accidental removal. This lesson covers daily stoma care in general terms, securing the tube, and mouth care. Key points: clean and dry the stoma site as the plan directs; check the site for redness, swelling, leaking or overgrown tissue; keep the tube secured and avoid pulling on it; only rotate or adjust a tube if the plan says so; and keep up regular mouth care even when the person has nothing by mouth.

Most feeding problems are easier to fix when they are noticed early. This lesson covers the complications you should look for and report, grouped into problems at the stoma site, problems with digestion and problems with the tube itself. Key points: report redness, swelling, heat, pain, pus, bleeding or leaking at the site; report nausea, vomiting, diarrhoea, constipation or bloating; report signs of aspiration such as coughing, fever or breathing changes; report weight change and signs of dehydration; and report a blocked tube rather than forcing it.

Some feeding tube problems are urgent. This lesson explains what to do if a tube comes out or moves, and when to call for emergency help. Key points: if a gastrostomy tube comes out, stop any feed, cover the stoma with a clean dressing, keep the tube and contact the person named in the plan straight away, because the stoma can begin to close within hours; only reinsert a tube if you are specifically trained and the plan allows it; do not use a tube that may have moved; and call triple zero for breathing difficulty, severe pain, heavy bleeding or collapse.

Clear records help the health team monitor how well enteral feeding is working and pick up problems early. This lesson covers what to record after each feed and how to report concerns and incidents. Key points: record the time, formula, volume, flushes, medication and how the person tolerated the feed; record stoma site checks and bowel motions if the plan asks; report concerns to your team leader the same day; report incidents such as a dislodged tube or a feeding error through our incident management system; and some incidents must be notified to the NDIS Commission.

This case study follows Thi, a woman with motor neurone disease who has a PEG tube and receives her evening feed through a pump. During the feed she slides down in bed and starts coughing. The lesson walks through how her support worker prepares the feed safely, recognises the warning signs, stops the feed and sits Thi upright, then follows the plan and reports. It also shows how Thi stays in control of her care. Key points: check the plan every time, keep the person upright, watch closely during feeds and act quickly on coughing or breathing changes.

This case study follows Ahmed, a young man with cerebral palsy who has a balloon gastrostomy tube and attends a day program. He loves the social side of lunch with his friends, even though he has nothing by mouth. During a transfer, his tube comes out. The lesson shows how his support worker includes him in mealtimes, what to do straight away when a tube comes out, why the tube should be kept and the stoma covered, and how to report. Key points: include the person socially, act fast when a tube comes out and never reinsert unless trained and authorised.