Be ALERT: Practice Safe Enteral Feeding

The harmful effects of malnutrition on the overall health of a patient have been well documented. Poor nutrition is associated with impaired recovery from illness and surgery. Wound healing and recovery require optimal nutritional intake.

Enteral Nutrition (EN) is the administration of nutrients directly into the gastrointestinal tract.  It is the preferred method for providing nutrition and is used when the patient’s GI tract is functional, as it is less invasive, has a lower risk for infection, and is safer than the parenteral method. Enteral nutrition also preserves the gut structure and function and is more cost effective than parental nutrition.

The American Society for Parental and Enteral Nutrition (ASPEN, 2009) recently released a safe practice guideline for enteral feeding. Recent reports from the Institute of Medicine’s quality reports have drawn attention to the substantial variations in care that exist both nationally and within local communities with regard to enteral feeding standards and practices. Working to standardize clinical care in accordance with evidence-based practice, this safe enteral feeding guideline offers healthcare providers the opportunity to ensure that the highest quality of care is delivered to all patients.

ASPEN’s “Be A.L.E.R.T” safety campaign calls attention to 5 core steps that must be followed when administering enteral feeds:
• Aseptic technique: When preparing enteral feeds, practice good hand washing techniques. Wear gloves when handling feeding tubes and avoid touching can tops,   container openings, spikes and spike ports.
• Label equipment: Labels should include the patient’s name and room number, the formula type and rate, the date and time of administration and the nurse’s initials.
• Elevate the head of the bed: Whenever clinically possible, the head of the bed should be elevated 30 degrees to mitigate the risk of reflux and aspiration of gastric content.
• Right patient, right formula, right tube: Match the formula and the rate to the patient’s order and verify that the enteral tubing set connects formula container to the feeding tube.
• Trace all lines and tubing back to the patient: Avoid misconnections by tracing all lines from origin to patient, and assure that all connections are enteral to enteral.

Following these steps can minimize complications of enteral feedings. For more information, visit ASPEN’s Guidelines and Standards Library at: http://www.nutritioncare.org/Library.aspx

American Society for Parental and Enteral Nutrition (2009) Clinical Guidelines. http://www.nutritioncare.org/lcontent.aspx?id=3544

"Parenteral Nutrition." Encyclopedia of Nursing & Allied Health. Ed. Kristine Krapp. Gale Cengage, 2002. eNotes.com. 2006. 26 Aug, 2009. http://www.enotes.com/nursing-encyclopedia/parenteral-nutrition