Title Page

  • Staff Member:

  • Date:

  • Assessor:

  • Location

Preparation? Giving the feed? Finishing?

  • Have the staff completed their online training regarding Enteral Feeding?

  • Have the staff washed their hands? Are staff wearing PPE?

  • Have staff identified their equipment and prepared what they need? (Formula, Water, 2 syringes, measuring cup)

Giving the Feed

  • Do staff know how mush flush/water to draw up in syringe? (100ml)

  • Do staff correctly attach the syringe to the correct section of the tube associated with the PEG?

  • Do staff apply the correct amount of pressure to the flush to push it through?

  • Do staff use the measuring jug to correctly measure out the correct volume of feed?

  • Do staff correctly push the feed through the PEG sight allowing time and not forcing the feed through the tube? Or do staff correctly lift the tube up and connect the syringe without a plunger to the tube and slowly pour the feed in allowing time for the feed to allow gravity to flow through?

  • Do staff correctly disconnect the syringe and repeat the flush process as before?

  • Do staff correctly clamp the tube afterwards?

  • Do staff correctly dispose of waste and wash hands post procedure?

Competency sign off

  • Are staff competent?

  • Any further training required?

  • Signature of Assessor

  • Date:

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