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Print Forrest Former completed, please fax to 866.583.9296Enteral Equipment and Supplies Prescription Provider Name:Patient Name:Phone:Date of Birth:NPI:Length of Need (in months)ICD10 code and written
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How to fill out enteral equipment and supplies
How to fill out enteral equipment and supplies
01
Gather all the necessary enteral equipment and supplies such as feeding pump, feeding bag, tubing, and formula.
02
Wash your hands thoroughly with soap and water before handling the equipment.
03
Set up the feeding pump according to the manufacturer's instructions.
04
Fill the feeding bag with the prescribed amount of formula.
05
Connect the tubing to the feeding bag and prime it to remove any air bubbles.
06
Attach the tubing to the pump and set the desired rate of feeding.
07
Make sure the patient is in a comfortable position and start the feeding process.
08
Monitor the feeding process closely and adjust the rate as needed.
09
Clean and store the enteral equipment and supplies properly after use.
Who needs enteral equipment and supplies?
01
Patients who are unable to take food or fluids orally due to medical conditions such as dysphagia, neurological disorders, or gastrointestinal issues.
02
Patients who require long-term or temporary tube feeding for nutritional support.
03
Individuals who are undergoing surgery or medical treatment that affects their ability to eat normally.
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What is enteral equipment and supplies?
Enteral equipment and supplies refer to items used for administering nutrition directly into the digestive tract.
Who is required to file enteral equipment and supplies?
Healthcare providers, facilities, and suppliers who provide enteral equipment and supplies are required to file.
How to fill out enteral equipment and supplies?
The enteral equipment and supplies form must be completed with detailed information about the items provided.
What is the purpose of enteral equipment and supplies?
The purpose of enteral equipment and supplies is to ensure that patients receive proper nutrition when they are unable to eat or drink normally.
What information must be reported on enteral equipment and supplies?
Information such as the type of equipment or supplies provided, quantity, and dates of service must be reported.
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