Enternal feeding

Specialties Home Health

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Hi nurses I have a question I am a recent graduate and just started orientation as an lpn I was following a nurse . She was giving a feeding to a pt it's the kangaroo Joey machine. She measured the amount of formula that's ordered for the pt and put it in the feeding bag. She primed it and checked that all the setting for the rate and volume is set up correctly in the machine, but when the bag is empty the machine says feeding error and the tubing is still filled with a lot of formula. She checked for any clogs or kinks in the tubing but there's nothing. And when she pressed the continue button it shows that there's still a certain amount like 4 ml's left for the feeding to be completed. What should be done if this was to keep on continuing?

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Specializes in NICU, ICU, PICU, Academia.

If this is an adult- 4 mL is within the acceptable margin of error for the machine I would think. I would question what she measured the formula with.

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These machines are not perfectly accurate. Four ml can be disregarded.

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Specializes in Pedi.

Did she account for the priming volume of the bag when she poured the formula in? 4 mL is negligible for an adult and, as the others have said, likely well within the margin of error for the Joey pump. I know the Joey has a larger margin of error than the Infinity, which is what we use for kids at home, and the Infinity's accuracy is +/- 5%.

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Yeah she did. At first I thought she did the measurement wrong but when I watched her do it again the second time the measurement was correct and the feeding was for a toddler and the machine did it again

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Specializes in Pedi.
Yeah she did. At first I thought she did the measurement wrong but when I watched her do it again the second time the measurement was correct and the feeding was for a toddler and the machine did it again

What was the volume of the formula in the bag and the volume to be dosed programmed into the pump?

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We use the kangaroo Joey pumps where I work and we've found them to be pretty inaccurate sometimes. For example I have one patient that gets 720ml per day, 624ml over 13 hours at night and then 96ml over 2 hours mid day. When she first changed to this feeding schedule we'd put 720ml in exactly, (3 cans) and program the pump to give 624ml. When the pump said that 624ml had been given there was very little left when there should have been 96ml. In reality there was only what looked like 40-50ml left in the bag and whatever amount that was left in the tubing. Not accounting for the mls for priming and maybe a few mls that remained coating the inside of the cans that's a pretty big discrepancy I think. Day shift would add an extra can so she'd get her 96ml but, insurance said they'd only pay for 3 cans per day, ugh so that became an issue and we can't add a little extra for priming. We tried I think 3 or 4 different pumps and they were all off. Now we run her pump till it reaches right below the 100ml mark on the bag and save the rest so she'll have 96ml for later. Once her 96ml runs in she gets a water flush so, she gets the mls left in the tubing and gets exactly 720ml for the day even if the pump says otherwise. We don't go by the count on the pump anymore but, when I cut it off in the mornings at 100ish mls left I'll check to see what it says and it's usually around the 575-590ml mark (not 624) give or take a few mls so, that's 30-50ish ml discrepancy. She also gets a 30ml q hr h20 flush so, I assume that messes with the count because, it gives what formula is in the tubing when flushing and doesn't account for it on the volume infused count. My guess it's that plus the amount in the tube for priming is what accounts for the discrepancy. Either way when you can only put a certain amount of formula in it can be frustrating when the count is off. Maybe the counts are off from the reasons I mentioned above, the kangaroo pumps are inaccurate or we've just had terrible luck with our pumps??

Personally I wouldn't worry too much about a 4ml discrepancy on the pump if the feedings all been given but, if there's formula left in the tubing I'll usually use the prime feed/flush option on the pump to push those last few mls in.

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Specializes in nurseline,med surg, PD.

By the way, it's not enternal feeding, it's enteral.

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Specializes in Pedi.
We use the kangaroo Joey pumps where I work and we've found them to be pretty inaccurate sometimes. For example I have one patient that gets 720ml per day, 624ml over 13 hours at night and then 96ml over 2 hours mid day. When she first changed to this feeding schedule we'd put 720ml in exactly, (3 cans) and program the pump to give 624ml. When the pump said that 624ml had been given there was very little left when there should have been 96ml. In reality there was only what looked like 40-50ml left in the bag and whatever amount that was left in the tubing. Not accounting for the mls for priming and maybe a few mls that remained coating the inside of the cans that's a pretty big discrepancy I think. Day shift would add an extra can so she'd get her 96ml but, insurance said they'd only pay for 3 cans per day, ugh so that became an issue and we can't add a little extra for priming. We tried I think 3 or 4 different pumps and they were all off. Now we run her pump till it reaches right below the 100ml mark on the bag and save the rest so she'll have 96ml for later. Once her 96ml runs in she gets a water flush so, she gets the mls left in the tubing and gets exactly 720ml for the day even if the pump says otherwise. We don't go by the count on the pump anymore but, when I cut it off in the mornings at 100ish mls left I'll check to see what it says and it's usually around the 575-590ml mark (not 624) give or take a few mls so, that's 30-50ish ml discrepancy. She also gets a 30ml q hr h20 flush so, I assume that messes with the count because, it gives what formula is in the tubing when flushing and doesn't account for it on the volume infused count. My guess it's that plus the amount in the tube for priming is what accounts for the discrepancy. Either way when you can only put a certain amount of formula in it can be frustrating when the count is off. Maybe the counts are off from the reasons I mentioned above, the kangaroo pumps are inaccurate or we've just had terrible luck with our pumps??

Personally I wouldn't worry too much about a 4ml discrepancy on the pump if the feedings all been given but, if there's formula left in the tubing I'll usually use the prime feed/flush option on the pump to push those last few mls in.

The Kangaroo people state that the Joey's accuracy is +/- 7%. So it appears to be operating within its listed accuracy based on your examples. When water is added, they admit that it overdelivers by 4%.

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