title: Enteral Feeding Set Handling Techniques.
abstract: BACKGROUND
  Enteral nutrition therapy is common practice in pediatric clinical settings. Often patients will receive a pump-assisted bolus feeding over 30 minutes several times per day using the same enteral feeding set (EFS). This study aims to determine the safest and most efficacious way to handle the EFS between feedings.
  
  
  METHODS
  Three EFS handling techniques were compared through simulation for bacterial growth, nursing time, and supply costs: (1) rinsing the EFS with sterile water after each feeding, (2) refrigerating the EFS between feedings, and (3) using a ready-to-hang (RTH) product maintained at room temperature. Cultures were obtained at baseline, hour 12, and hour 21 of the 24-hour cycle. A time-in-motion analysis was conducted and reported in average number of seconds to complete each procedure. Supply costs were inventoried for 1 month comparing the actual usage to our estimated usage.
  
  
  RESULTS
  Of 1080 cultures obtained, the overall bacterial growth rate was 8.7%. The rinse and refrigeration techniques displayed similar bacterial growth (11.4% vs 10.3%, P = .63). The RTH technique displayed the least bacterial growth of any method (4.4%, P = .002). The time analysis in minutes showed the rinse method was the most time-consuming (44.8 ± 2.7) vs refrigeration (35.8 ± 2.6) and RTH (31.08 ± 0.6) ( P < .0001).
  
  
  CONCLUSIONS
  All 3 EFS handling techniques displayed low bacterial growth. RTH was superior in bacterial growth, nursing time, and supply costs. Since not all pediatric formulas are available in RTH, we conclude that refrigerating the EFS between uses is the next most efficacious method for handling the EFS between bolus feeds.
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Lyman
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Williams
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Sollazzo
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Hayden
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Pam
authors.initials: P
authors.lastname: Hensley
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: 1 Children's Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Cristine
authors.initials: C
authors.lastname: Roberts
mesh_terms: D015169:Colony Count, Microbial; D004750:Enteral Nutrition / Q000191:economics / Q000379:methods* / Q000451:nursing; D004866:Equipment Contamination / Q000517:prevention & control; D005516:Food Microbiology; D006801:Humans; D007260:Infusion Pumps; D057947:Parenteral Nutrition Solutions / Q000737:chemistry* / Q000191:economics; D010372:Pediatrics; D012034:Refrigeration
chemical_list: D057947:Parenteral Nutrition Solutions
keywords: bacteria; enteral nutrition; food safety; infection control; pediatrics; safety; tube feeding