Nurse Delegation with complex feeding

[wellnavy]

I need some feedback about a situation I have involving a patient wiyh complex feeding needs.

The DX is MS.

Patient has a neurological related gag sensitivity.

Patient has orsl aversion.

Sensations felt involving chewing, taste, texture and swallowing vary wildly, throughout the day. This would require continuous assessment to ascertain proper feeding requirements for every feeding.

Patient has MS related skin sensitivity issues as well as general skin sensitivity issues pertaining to breakdown risk. For this reason the patient is averse to having a peg tube applied.

Question: Does this patient require skilled services to perform their feedings? Us a feeding as complex as this able to be safely performed by a non skilled aid?

Thanks for any feedback,

[traumaRUs, MSN, APRN]

Moved to long term care

[amoLucia]

Has the Speech Therapist been consulted and is there a swallowing eval (with like a swallow done at the hospital)? I'm guessing that something's been done along those lines, so recommendations should have been written. That should tell you how much skill is required to safely feed this pt. And that's what should be guiding your feeding approach.

What about your dietary consultant? They're usually on top of these types of pts with special needs. Just remember if there are special procedures, they need to be care-planned and staff need to be educated/trained on them as nec.

Sometimes, there have been occasions where only licensed nsg (RNs & LPNs) were to feed pts.

Check to see if those consults or recommendations can shed some light.