ALERT: How long can enteral feeding bags be used for?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
ALERT: How long can enteral feeding bags be used for?
SITUATION:
This QuickHit was informed by recent backorders on enteral feeding equipment and supplies which has resulted in a shortage and challenges with access to enteral feeding bags in home and community.
BACKGROUND:
Many children with medical complexity rely on enteral feeding tubes to support nutrition, hydration, and/or medication administration in home and community. There are several methods of administration that can be used to safely administer feeds, fluids and/or medication including syringe, gravity, and pump. In choosing the most appropriate method of enteral feeding, considerations include safety of the patient, access and costs of equipment, ease of use and portability, and family caregiver preferences.
Recent backorders and supply chain issues have resulted in a shortage and challenges with access to feeding bags for use with enteral pumps in home and community. The backorders have the most significant impact on enteral feeding bags that are used with the Kangaroo ePump and Kangaroo Joey feeding pumps.
ASSESSMENT:
In home and community care, there are there are different infection control considerations than in the hospital environment. There may also be supply chain challenges and the need to limit out-of-pocket expenses for family caregivers, influencing their choice to reuse some of their supplies. Proper cleaning of enteral feeding bags can help extend their use and limit the need for frequent replacements. The frequency of changing feeding bags is typically based on the type of feed being administered (e.g. formula vs blenderized diet), and the use of good cleaning practices.
RECOMMENDATION:
Connected Care recommends enteral feeding bags can be used for up to one week if functioning well, with no visible defects or soiling. When possible, practice careful preservation of home care supplies, especially in light of supply chain shortages.
The following practices for cleaning and reusing enteral feeding bags in home and community are suggested:
At the start of each shift, determine how long the feeding bag has been in use and label it with the disposal date if one isn’t in place.
Before each use, visibly inspect the feeding bags and determine if it can be reused - that it has no cracks, isn’t broken, nor visibly soiled.
After each use, clean enteral feeding bags thoroughly with warm, soapy water. Alternatively, a mixture of one part vinegar and one part water may also be used.
After thorough cleaning and rinsing, allow the feeding bag to air dry between feeds by hanging it (e.g. on a hook) or placing it on a clean dry surface (e.g. on a towel).
Consider that feeding supplies may need to be cleaned more often when a child has thick formula recipes that stick or leave residue on the bags (e.g. blenderized diet).
Track the supply of feeding bags and related supplies and contact local vendors to confirm availability of new stock/supplies to the home. Due to current backorders, vendors may have restrictions on the amount of feeding bags that can be purchased.
If there are anticipated backorders on the child’s enteral feeding equipment and supplies, that will affect the ability to deliver feeds, contact the child’s healthcare provider who orders their feeds or their registered dietician to explore alternative options for enteral feeding (e.g. use of a different pump, gravity feeds or other method of feeding if appropriate)
Homecare nurses and other providers are encouraged to partner with family caregivers to understand their preferred method of cleaning and reuse of enteral feeding bags.
Review the AboutKidsHealth Tube Feeding Learning Hub for additional information and resources on maintenance of equipment and supplies
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