Combined Assessment Program Summary Report – Enteral Nutrition Safety in Veterans Health Administration Facilities

OIG completed an evaluation of the management of enteral nutrition (EN) safety in Veterans Health Administration (VHA) facilities. The purposes of the evaluation were to determine whether facilities complied with Joint Commission standards and VHA requirements to: (1) establish and implement EN policies and practices, (2) manage and document EN care in the electronic health record, and (3) provide continuity of care for patients receiving EN. We also determined whether facilities incorporated selected safe EN practices as recommended by the American Society for Parenteral and Enteral Nutrition. OIG conducted this review at 27 facilities during Combined Assessment Program reviews performed from April 1–September 30, 2011, and identified five areas with opportunities for improvement. OIG recommended that current VHA requirements be evaluated and revised to include applicable industry recommendations regarding EN safety practices and documentation. OIG also recommended that facility policies and practices address all VHA-required EN elements; that electronic health record documentation consistently includes all VHA-required EN elements; that clinicians provide EN education for patients discharged on EN and/or their caregivers; and that facilities strengthen continuity of care processes for follow-up and monitoring of patients discharged on EN.