30/03/2026
NDIS educators and support workers need to link PEG care to infection-control fundamentals, the participant-specific enteral feeding plan and the High Intensity Support Skills Descriptors for enteral feeding, not just "tube skills". Preventing PEG site infections is mostly about consistent hygiene, correct site care, early recognition of change, and knowing when to escalate.
Core Responsibilities within the NDIS sector:
* Workers must understand and follow the participant's current enteral feeding plan, including how often to clean, rotate, and inspect the site, and what to do if they see any change.
* The NDIS high-intensity skills descriptors expect workers to:
- perform hand hygiene
- set up a clean environment
- recognise risks like infection and leakage, and escalate promptly according to the care plan and organisational policies
- be accountable for monitoring, documenting, and escalation early signs of infection.
General Principles with ongoing care, after initial healing:
- Thorough hand washing with soap and water before and after enteral feeding handling, and use of gloves if there is contact with bodily fluids or dressings.
- Clean the skin around the PEG once or twice daily with mild soap and tap water, gently removing crusts or exudates, then dry completely with a gauze
- keep the site dry; moisture and warmth under the fl**ge or dressing increase infection risk, so dressings should only be used when ordered and changed as soon as they are damp or soiled.
Fl**ge/ bumper and tube positioning:
- Check that the external bumper is not too tight (can cause pressure injury, leakage, and infection) and not too loose (can cause friction, leakage and skin maceration)
- Once the tract has healed, rotate the tube as instructed (i.e 360 degrees daily or weekly) to prevent tissue overgrowth and buried bumper, but workers should only adjust or rotate according to the written clinical plan.
Inspection and documentation:
- Inspect the site at least once per shift (and before feeds) for redness, swelling, warmth, increased pain, new or worsening leakage, odour, or pus and record
- Document cleaning (date and time, what was done) and any changes from baseline so patterns are visible to clinicians and educators
Before and after feeds or medications
- Before each feed/flush/medication: perform hand hygiene, confirm tube position/length markings, check the bumper, and visually inspect the skin for early infection signs or leakage.
- If the site looks more red, swollen, painful, or has new discharge compared with usual, or if leakage has increased, pause non‑urgent feeds and follow the escalation steps in the participant’s plan (e.g., call RN, GP, or after‑hours service).
- After feeds/medications: wipe away any spilt formula or medication from the skin, ensure the site is dry, secure the tube to prevent traction, and re‑check that the clamp and giving‑set connections are not stressing the stoma.
Educators should ensure workers know:
Red flags requiring urgent escalation, such as: rapidly spreading redness, marked warmth and swelling, pus or foul odour, fever or rigors, severe pain at or around the site, or systemic deterioration.
Who to contact and in what order (e.g., supervising RN, coordinator, GP, PEG nurse, emergency department) and what information to provide (baseline, what changed, when, what actions already taken).
That suspected PEG‑site infection is both a clinical issue and, for high‑intensity supports, a matter for incident/risk documentation and quality review under the NDIS Practice Standards.
If you want, KaiCare can provide you with a free one-page cheat sheet for a quick reference guide. DM me if you'd like a copy. Happy to support families and teams navigating complex care.
