Essential steps to safe, clean care
Reducing healthcare-associated infections in Primary care trusts; Mental health trusts; Learning disability organisations; Independent healthcare; Care homes; Hospices; GP practices and Ambulance services.
To reduce the risk of infection associated with enteral feeding
• Preparation and storage of feeds • Administration of feeds • Care of insertion site and enteral feeding tube • Preventing the spread of infection
Enteral feeding means using the gastrointestinal tract for the delivery of nutrients, which includes eating food, consuming oral supplements and all types of tube feeding. This method of feeding has resulted in a range of different routes and systems for delivery of nutrition, and more patients are now being fed by home enteral feeding tubes in the community setting. The need for education and training in infection prevention and control is vital for the provision of the clean and safe care of all enteral feeding systems. The National Institute for Health and Clinical Excellence found that 30% of feeds were contaminated with a variety of microorganisms, largely due to the poor preparation or poor administration of feeds, (NICE 2003). The research found that the rates of contamination were highest in home settings and thus reinforces the need to focus on infection prevention and control practices within the community setting. These should be read in conjunction with Essential steps to safe, clean care: Preventing the spread of infection.
Risk elements and safety actions
The risk elements of the care process listed below are based on the NICE guidelines (NICE, 2003) The risk elements form the basis of reducing the risk of infection, and the safety action points indicate how the risk elements should be carried out. The list of elements and safety action points are not meant to replace existing guidelines but to act as a simple method for improving the reliability of the clinical process. Where local guidance and policies already exist, their use in clinical practice can be assessed by using this intervention, or by tailoring the review tool to meet local needs. The risk elements are divided into three distinct interventions: • Preparation and storage of feeds • Administration of feeds • Care of insertion site and enteral feeding tube Education of patients/clients, their carers and healthcare personnel should be integral to all risk elements. These guidelines should be read in conjunction with the Essential steps to safe, clean care: Preventing the spread of infection.
Preparation and storage of feeds
• Feeds should be stored according to manufacturers’ instructions and, where applicable, food hygiene legislation.
Administration of feeds
• Minimal handling and an aseptic non-touch technique should be used to connect the feed container administration system and enteral feeding tube.
Care of insertion site and enteral feeding tube
• The stoma should be washed daily with water and dried thoroughly. • The enteral feeding tube should be flushed with fresh tap water before and after feeding or administrating medications. Enteral feeding tubes for patients who are immunosuppressed should be flushed with either cooled freshly boiled water or sterile water from a freshly opened container.
Preventing the spread of infection
• Refer to the Essential steps to safe, clean care: Preventing the spread of infection.
National Institute for Health and Clinical Excellence (2003) Infection control. Prevention of healthcare associated infection in primary and community care. Department of Health, London. www.nice.org.uk/page.aspx?o=CG002
Essential steps to safe, clean care
Reducing healthcare-associated infections in Primary care trusts; Mental health trusts; Learning disability organisations; Independent healthcare; Care homes; Hospices; GP practices and Ambulance services....
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