By Sara Glanz, MS, RD, LD, CNSC
If you work with patients who receive tube feeding, you may have noticed that the hardware connecting formula to feeding tube is a bit different. These new connectors, called ENFit®, are part of an international patient safety effort. Here’s what you need to know.
Why the Change?
In 2006, The Joint Commission issued a patient safety alert regarding misconnections of enteral feeding, intravenous medications, and oxygen leading to patient harm and death. The organization recommended changes be made to the actual hardware to physically prevent misconnections, thereby increasing patient safety. Enteral nutrition connectors were one of the first devices to be changed. Given the magnitude of the change, the implementation has been lengthy, with coordinated efforts by suppliers, clinicians, and facilities.
How are the ENFit® Connectors Different?
The image above demonstrates how ENFit® is different. Previously, the same Luer-type syringes and connectors could be used with both IV tubing and feeding tubes, creating the potential for serious errors. ENFit® utilizes a notched design and twisting mechanism to ensure that enteral formula can only be infused into an enteral feeding tube. As you can see in the diagram, suppliers have created a transitional connecting device to be used until all feeding tubes, pump sets, and syringes have completely transitioned to ENFit®. Please note that this is only meant to be a temporary workaround, rather than a substitute for full adoption of ENFit®.
What is the Dietitian’s Role in the Change?
- First, educate yourself on the change. Know exactly what is changing, when, and why. If you would like to read more on the ENFit® connectors, visit StayConnected.org. This website has implementation checklists, educational videos, implementation success stories, FAQs, and more.
- Reach out to your supply chain representatives and facility educators to see where your facility is in the transition process. Offer help, as needed. As the nutrition expert, you are poised to champion this change!
- Educate patients and caregivers. One hiccup in the ENFit® transition may be patients who are long-time tube feeders. Patients who have had permanent feeding tubes in place for several months or years may need extra help in figuring out how this change will affect them, depending on what supplies they receive and how they administer their tube feeding formula.
- Continue to reinforce the change with staff. ENFit® is not going away, as it is an initiative sponsored by The Joint Commission and the FDA, and it will eventually be adopted worldwide. For the sake of patient safety, don’t slip back into old habits or use the transitional connectors when ENFit® can be used. Keep moving forward to enhance patient care and safety.
Tips for keeping ENFit feeding tube ports clean. Inspect before you connect!
Sara Glanz, MS, RD, LD, CNSC is a travel dietitian for Dietitians On Demand. She is passionate about empowering dietitians to be more involved with the interdisciplinary healthcare team. Her favorite adventures while on assignment include: The 17-Mile Drive in Monterey, CA; Lake Placid, NY; Montreal, Canada; and of course, the Jelly Belly® Jelly Bean and Ben & Jerry’s® ice cream factories located in Fairfield, CA and Burlington, VT, respectively.
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Enteral Feeding Connectors (ENFit®). GEDSA website http://stayconnected.org/enteral-enfit/. Updated 2017. Accessed December 21, 2017.