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8.18 Enteral feeding tubes: administration of feed using an enteral feeding pump

Essential equipment

  • Personal protective equipment
  • 60 mL ENFit‐compatible syringe
  • Enteral feeding pump
  • ENfit‐compliant giving set
  • Commercial ready‐to‐hang feed

Optional equipment

  • Freshly drawn tap water for patients who are not immunosuppressed, and either cooled freshly boiled water or sterile water from a freshly opened container for patients who are immunosuppressed (NICE [119]) (keep water covered)

Pre‐procedure

ActionRationale

  1. 1.
    Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
    To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [126], C).
  2. 2.
    Decontaminate hands either by washing with soap and water or with an alcohol‐based handrub. Apply personal protective equipment.
    To minimize the risk of cross‐contamination ([115], C).

Procedure

  1. 3.
    Check the date on the feed container.
    To ensure that the feed has not passed its expiry date. E
  2. 4.
    Shake the feed container gently.
    To ensure the feed is evenly dispersed, thereby reducing the risk of blocking the giving set. E
  3. 5.
    Take a new giving set from a sealed package and ensure that the roller clamp/tap is closed.
    To avoid accidental spillage of feed from the end of the administration set. E
  4. 6.
    Screw the giving set tightly onto the feed container.
    To pierce the seal on the container and maintain a sealed system (Matlow et al. [97], C).
  5. 7.
    Hang the container upside down from the hook on a drip stand.
    To avoid backflow of intestinal contents into the feed container (Matlow et al. [97], E).
  6. 8.
    Feed the giving set into the pump as directed by the manufacturer's instructions.
    To connect the giving set to the pump device. E
  7. 9.
    Open the roller clamp/tap and prime the feed to the end of the giving set. (Follow instructions for individual pump.)
    To ensure that air is not fed into the stomach when feeding commences. E
  8. 10.
    Set the rate of the feed as directed by the manufacturer's instructions and according to the patient's feeding regimen.
    To ensure the correct rate of feed is administered. E
  9. 11.
    Set the dose of the feed as directed by the manufacturer's instructions and according to the patient's feeding regimen.
    To ensure that the correct dose of feed is administered. E
  10. 12.
    Flush the feeding tube with a minimum of 30 mL of water or sterile water in an ENFit syringe by attaching the syringe to the end of the feeding tube. Depress the plunger on the syringe slowly.
    To ensure the patency of the feeding tube (BAPEN [13], C).
  11. 13.
    Remove the end cover from the giving set and connect it to the feeding tube.
    To ensure that the feed is delivered via the enteral feeding tube. E
  12. 14.
    Commence administration of the feed.
    To ensure that the feed is delivered via the enteral feeding tube. E

Post‐procedure

  1. 15.
    Dispose of any equipment that is no longer required.
    To reduce the chance of equipment being reused and to reduce the risk of cross‐contamination with new equipment. E
  2. 16.
    Document the time that the feed commenced and the rate of administration.
    To ensure accurate documentation of nutritional and fluid intake (NMC [126], C).
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