QUIZ: How Well Do You Know NICU Enteral Feeding Safety Recommendations?

Patrice Hatcher, MBA, BSN, RNC-NIC / August 2016

Over the past several years, enteral feeding safety has risen to a high level of concern related to misconnections with enteral feeding tubing.

In 2014, the Joint Commission put out a call to action that included strategies for managing enteral feeding and decreasing the risk of tubing misconnections. These days we are all very familiar with these strategies, especially in the NICU.

The American Society for Parenteral and Enteral Nutrition (ASPEN) enteral nutrition practice recommendations are clinical guidelines that are based on expert opinion and best practices designed with the goal of improving enteral patient safety. The more familiar you are with these recommendations, the easier it will be to incorporate them into your daily practice and improve patient safety.

While many of us in neonatal intensive care have been well-educated on these guidelines, it is always good to stay updated and keep them top-of-mind.

Test Your Knowledge

The following 10 statements are based on Joint Commission regulations and ASPEN Guidelines for safe enteral feeding practices. Answer each one as true or false. Keep track of your true or false answers and compare them to the correct answers (listed below the questions). Good luck!

  1. Use tubing and equipment as it is intended and don’t interchange IV and enteral equipment or products.   True / False
  2. Use distinctly different syringe pumps for enteral feeding than the ones used for intravenous fluids and medication.  True / False
  3. Prior to connecting or reconnecting any device or infusion, trace tubing from the patient to the point of origin.   True / False
  4. Label or color-code feeding tubes and connectors, and educate staff about the labeling and color-coding process in the institution.   True / False
  5. Safe enteral feeding practice includes using temporary adapters and forcing connections whenever possible.   True / False
  6. It is important to have an adequate number of enteral-only syringe pumps to support consistency with practice; IV pumps are not to be used for enteral feeds.   True / False
  7. Refrain from having access on unit to enteral products that can connect with female luer connectors and/or enteral feeding sets compatible with female luer connectors.   True / False
  8. Enteral feeding pumps used for enteral delivery should be clearly labeled and identifiable as enteral feeding pumps.   True / False
  9. As part of a hand-off communication process, clinicians should recheck connections and trace all tubes back to their original origin.   True / False
  10. Train non-clinical staff and visitors not to reconnect enteral and IV tubing, and instead to seek clinical assistance.   True / False

1 true, 2 true, 3 true, 4 true, 5 false, 6 true, 7 true, 8 true, 9 true, 10 true

How did you do? Let us know! Use the comments section below to share your results.

About the Author

Patrice Hatcher, MBA, BSN, RNC-NIC,  began her practice more than 24 years ago as a neonatal nurse working in NICU. She has experience in various nursing leadership roles including neonatal transport nurse, outpatient nurse manager, and administrative nurse manager overseeing operations of large intensive care units.   She has special interest in quality improvement and improving clinical outcomes for neonates.   Patrice currently works full-time as a Clinical NICU Specialist for Medela, Inc.