Can PT or CNA feed a stroke pt

TigraRN · Apr 8, 2018

That would generally depend on whether the patient passed swallow eval by the speech therapist. Let's say they indeed were evaluated and were able to eat pureed food and drink thickened liquids, then the answer would be yes, CNA can feed the patient. Not sure about PT.

Sour Lemon · Apr 8, 2018

A stroke pt having difficulty swallowing needs assistance eating besides thickening agents and raising HOB can you delegate the feeding legally to a PT or CNA??

Of course ...but like any other task, you must assess the CNA's competency, first.

Okami_CCRN, BSN, RN · Apr 8, 2018

Legally, yes the CNA and PCT have the ability to feed patients. The real question here is should they?

If a stroke patient has such difficulty swallowing that they require more assistance than increasing the HOB >60 degrees and utilizing thickened liquids, then the RN should feed the patient for the first few meals to assess their ability and determine what is the best possible way to feed them to prevent pocketing and aspiration.

If you are noticing that the patient is coughing between bites it may be time to have speech re-evaluate their ability to swallow.

Here.I.Stand, BSN, RN · Apr 8, 2018

As an LTC CNA, the CNAs invariably fed the residents; we had MANY folks with dysphagia diets.

All modifications -- e.g. thickened liquids, texture modifications, no straws etc -- are care planned. The CNA isn't in the dark about the modifications. If we had noted any issues e.g. seeing pocketed food in tre res's open mouth, it was expected that we report those to the RN/LPN.

Actually if there are any new or worsening concerns, an RN can't even feed the person. The SLP must assess first. They determine what if any modifications are required, document them, and the nurse then adds it to the nursing care plan.

Meriwhen, ASN, BSN, MSN, RN · Apr 8, 2018

Remember that as the RN, you are responsible for all of the patient's care, including the care that you delegate to LVNs/CNAs/PTs/etc. So you would need to assess the patient first to determine if this is a task that could be safely delegated to other personnel. That means assessing both the patient and the staff member to which you wish to delegate the task.

In this case, it might be ok for the PT to feed them...or then again, it might not. That depends on what your assessments show.

Here.I.Stand, BSN, RN · Apr 8, 2018

"PT or CNA?" Did you mean PCT as in pt care tech? Nurses don't delegate to physical therapists.

KelRN215, BSN, RN · Apr 8, 2018

Feeding a patient isn't the PT's job. PT's are busy providing PT. If any therapist was going to feed a patient, it would be the SLP or maybe an OT but they would more be working on skills than sitting there feeding the patient a meal. Of course a CNA can feed a stroke patient who's been cleared to take thickened feeds/fluids.