Gastrostomy Feeding Button Care
- Is used as alternative feeding device for an ambulatory patient receiving a long term enteral feedings.
- It’s approved for 6-month implantation and can replace gastrostomy tubes.
- The button is inserted into an established stoma and lies almost flush with skin; only the top of the safety plug is visible.
- Advantages over ordinary feeding tubes include cosmetic, appeal, ease of maintenance, reduced skin irrigation and breakdown, and less chance of being dislodged or migrating.
- The button has a one-way antireflux valve inside a mushroom dome that prevents leakage of gastric contents; its usually replaced every 3 to 4 months, typically because the antireflux valve wears out.
- Intestinal obstruction that prohibits use of the bowel
- Diffuse peritonitis
- Intractable vomiting
- Paralytic ileus
- Severe diarrhea
- Use cautiously in patients with severe pancreatitis, enterocutaneous fistulae, and GI ischemia.
- Gastrostomy feeding button of correct size
- Water-soluble lubricant
- Feeding accessories
- Catheter clamp
- Cleaning equipment
- I,V pole and pump
- Reinforce the explanation of the insertion, reinsertion, and feeding procedure to the patient.
- Verify the patient’s identity using two patient identifiers, such as the patient’s name and identification number.
- Make sure signed consent has been obtained.
Providing feedings through the feeding button
- Wash hands and put on gloves; monitor the patient’s bowel sounds, if absent, withhold the feeding and notify the physician.
- Attach the adapter and feeding catheter to the syringe
- Clamp the catheter and fill the syringe or bag catheter with formula.
- Open the safety plug and attach the adapter and feeding catheter to the button.
- Elevate the syringe or feeding bag above stomach level, and gravity-feed the formula for 15 to 30 minutes, varying the height as needed to alter the infusion rate.
- Use an administration pump for a continuous infusion or for feedings lasting several hours.
- Refill the syringe before it’s empty to prevent air from entering the stomach and distending the abdomen.
- After the feeding, flush the button with 10ml of water.
- Lower the syringe or bag below stomach level to allow burping.
- Remove the adapter and feeding catheter.
- Snap the safety plug in place to keep the lumen clean and prevent leakage if the antireflux valve fails.
- Wash the catheter and syringe or feeding bag in warm, soapy water and rinse thoroughly.
- Clean the catheter and adapter with a pipe cleaner.
- Rinse well before using for the next feeding.
- Soak the equipment weekly.
- Keep an extra feeding button at the bedside.
- Once daily, clean the peristomal skin with mild soap and water or providone iodine.
- Clean the peristomal site whenever the feeding bag is spilled.
- Reinforce with the patient how the gastrostomy feeding button is inserted and cared for.
- Remind the patient how to use the button for feedings.
- Reinforce how to clean the equipment and provide peristomal skin care.
- Nausea and vomiting, abdominal distention, exit-site infection, exit-site leakage, and peritonitis.