Can any nurses help answer this question?

[callmeadoctor]

Just an odd thing happening with my child currently in hospital. They have a peg feed for their food and meds. Every time they receive their meds (and flush), the nurse uses the cup that is next to their water jug. Doesn't clean it either before or after. Now I know it is going to their tummy anyway, but surely their training would say this is not good practice?
Also when they put movicol powder in the water, they wrap up the movicol wrapper and use it to mix the solution (surely then its not sterile? All the nurses do it so it seems standard practice, but seems so wrong? (The other day one used my coffee cup that hadn't been washed.......)

Ignore the vote button

It should be sterile water for flushes in hospital, that is locally but it's then cooled boiled water at home so tap water wouldn't be appropriate if that's what they're using

You should DEFO say something. Using a dirty coffee cup? I'd not be happy and I'd be speaking to someone higher up if I was you

Can be tap water within my trust but agree should be from a clean container.
Using the wrapped to mix movicol is grim and not acceptable, we mix in a clean bottle and shake.
I would report this it is poor practice, hope you get this sorted.

Yes, they do always use sterile water. Its just odd that they grab a random cup thats lying around. I can't believe that its normal practice, but every nurse does it, quite bizarre. The movicol wrapper to stir seems common practice too!

Mmmm, ok glad its not common practice. how strange though.

Omg they use the wrapper to stir the movicol that's awful and bad practice I would be asking about that

If it's in to the stomach here it can be tap water once the child is over a year old, if it's going via a jej it always has to be cooled, boiled water and no, it is not acceptable to stir movicol with the wrapper.

even if its tap water it still needs to be a clean cup 😳

Our trust states tap water and clean cup, but does not need to be sterile. We got thought to keep it as clean as you would if you where drinking from a cup of water. E.g. you wouldn't drink from a cup that had been standing for four hours, but you would go and sterilize your cup. They should not be using the packet to mix the movicol, regardless of if this is a peg or if you was giving to a patient to drink orally. I hope this helps.

Wouldn't sterilize your cup, not would

Dreadful practice I'd be complaining!

Thank you all xx

For a PEG, you can use tap water because the stomach acid will kill any germs. For a JEG you need to use sterile water because it bypasses the stomach acid. They should be using a clean cup though.

NICE guidelines

In my trust any PEG, NG, JEJ we have get sterile water, it's overkill for a PEG but it simplifies our guidelines.

Our cups aren't sterile but we use clean disposable paper cups each time and we use plastic spoons to stir. If I was in a pinch and hadn't taken in a spoon I'd use a 10ml syringe to stir instead since there's always loads in my medicine trolley. I'd never use a movicol wrapper.

We would use cool boiled water in our trust, but it would be put into a sterile baby bottle and labelled to change regularly. Would never make up movicol and use the wrapper to stir it either.

So, the nurses are putting tap water to use as a flush in a used coffee cup before drawing it into the syringe to flush the PEG? In my hospital we have little bottles of sterile water that we use, which might be excessive, but I doubt any hospital states as policy that tap water in a mug is right. Did your DD have her PEG inserted in that hospital? What were you taught to use at home? We make up Movicol in sterile containers that have lids and just shake until it's dissolved. Again, probably excessive but it is what we do. Otherwise, I would use a syringe to stir. Out of interest, what do parents do at home with movicol?

The OP has clarified they are using sterile water.
No definitely not ok to use dirty cups or the movicol packets to stir with.
Absolutely have a word with them.

It doesn't seem clean using the non sterile wrapper to stir.

Out of interest, what do parents do at home with movicol? I put it into a cup of water, with a splash of cordial to hide the evidence and stir.

@EmeraldShamrock, are you asking about orally with the movicol??

Thank you all, yes they use sterile water in the hospital (we are not at home), but as I say they seem to just look for the nearest cup (used or unused) to mix either the meds going in (and the flush) or the movicol (which always seems to be the nurse folding up the movicol wrapper to mix with, which seems daft because they open up a sterile syringe to use, why they don't use that to mix it up?)
Anyway thank you all for your thoughts. Difficult to know what to do because if we complain, they will know its us that have complained and our child is in their hands, so you don't want to rock the boat

The reason we have been so weirded out by it is that the cup is put back afterwards (without washing) next to their drinking jug. So the next drink is from the unwashed cup that peg meds have been in which seems all sorts of wrong.

Is your child nil by mouth? Could it be that the water and cup is put there each morning just to be used for the peg? And maybe they picked up the coffee cup by mistake?

I was taught to use the movical wrapper and never thought anything of it but I dont work in a hospital.

No, not nil by mouth at all. Jug of water and cup to drink from....... Interesting that you were taught to use the movicol wrapper though, how strange!