Home enteral tube feeding in patients with inherited metabolic disorders: safety issues

Evans, Sharon; MacDonald, Anita; Daly, Anne; Hopkins, V.; Holden, Chris

doi:10.1111/j.1365-277x.2007.00816.x

Cited by 14 publications

(18 citation statements)

References 5 publications

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“…The potential unreliability of pumps can be a source of stress not only for staff and caregivers but also for patients, including those in home settings, who may be concerned when fluid remains in delivery containers at the end of a programmed pump delivery period or, to the contrary, if feeding infuses more quickly than expected. In 1 study of home EN in 34 pediatric patients with inherited metabolic disorders, 75% of families of children surveyed reported sleep disturbances related to alarms, and 50% of home patients experienced faulty pumps that affected accuracy and, in 1 critical incident, led to underfeeding 47 . These authors published the review of enteral pumps, suggesting that formula delivery is accurate to within ±10% of what is programmed.…”

Section: Section 6 Administration: Generalmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

338

531

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Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

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Section: Section 6 Administration: Generalmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

338

531

View full text Add to dashboard Cite

show abstract

“…Of the limited accounts gathered from patients, their concerns have centered on the impact of incorrect equipment delivery, the longer-term issues of tube blockage, and the sleep disturbances related to activation of pump alarms for an unknown reason 64. The studies that have captured the experiences of caregivers and parents have explored their concerns regarding faulty or damaged pumps and the changes that have ensued after moving to a different enteral feeding pump company provider, rather than their preferences or views on enteral feeding pumps themselves.…”

Section: Patient Perceptions Of Use Of Enteral Feeding Pumpsmentioning

confidence: 99%

“…In a second study, Evans et al focused on overnight enteral feeding in children with metabolic disorders who required a high degree of pump accuracy and consistency to avoid destabilization of blood biochemical indices overnight 64. A significant number of safety issues were highlighted.…”

Section: Patient Perceptions Of Use Of Enteral Feeding Pumpsmentioning

confidence: 99%

“…Ambulatory pumps offer an option for return to normality, particularly for children 65,66. In support of the need for portable equipment, Evans et al provided current context, indicating that 82% of the study subjects were mobile, and 90% had ambulatory pumps in backpacks 64. Changing trends in the age distribution of children on enteral tube feeds are also apparent.…”

Section: Patient Perceptions Of Use Of Enteral Feeding Pumpsmentioning

confidence: 99%

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Enteral feeding pumps: efficacy, safety, and patient acceptability

White¹,

King²

2014

MDER

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Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump); and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field.

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“…It is often assumed that patients and their families are knowledgeable and proficient in administering EF if they have been trained to a high standard in a hospital environment. Two studies specifically examining practical issues associated with HETF in our own centre indicated that there are many practical difficulties,3 4 and some may affect patient safety. Problems included accidental or intentional tube dislodgement, pump inaccuracy, and frequent tube blockages.…”

mentioning

confidence: 99%