Section: UTMB On-line Documentation Subject: Healthcare Epidemiology Policies and Procedures Topic: Preparation of Enteral Feedings (Adult and Pediatric)

1.24 - Policy 04.06.09 - Revised 1998 - Author

1.24 Preparation of Enteral Feedings (Adult and Pediatric)

Purpose	To prevent the ingestion of contaminated liquid feedings that could result in illness either through infection or intoxication.
Audience	All employees of UTMB hospitals and clinics, contract workers, volunteers, and students involved in enteral feedings.
Physical Facility	• All enteral feedings must be prepared in a specific location that encourages the use of aseptic technique and ensures the delivery of safe enteral feedings. • A handwashing facility must be in close proximity to the enteral feeding preparation area. Hands must be washed or an alcohol hand rub applied to the hands prior to preparing formula.
Preparation and Handling Procedure	• Gather supplies. • Check manufacturer’s expiration date before using. • Wash hands or apply an alcohol hand rub to the hands and wear gloves. • Wash the top of the can with soap and water before preparing formula. • Cover open cans securely with a clean cover before refrigerating. • Use aseptic no-touch technique when measuring and placing feeding tube. • Use sterile water to add to liquid concentrate formula or to reconstitute powder formula. • All equipment and utensils (i.e., measuring spoons, can openers) used in the preparation of formula must be properly cleaned with soap and water between batches. • Medications should not be added during preparation of formula. Medications may be added at the bedside or at feeding time. • Formula bags must be labeled with: - Patient name - Formula name and additives - Expiration date and time • Clean blender thoroughly with dish washing soap (blender blade and “O” ring should be removed from base and cleaned separately) and allow to completely dry before storage.
Storage of Formula / Feedings	• Containers should be stored in a cool dry area when not in use. • Once opened, canned, ready-to-feed formula must be used immediately and not stored at the bedside or in the refrigerator. • Reconstituted or diluted formula should be used immediately, but any unused portion may be refrigerated for 24 hours. • Formulas must not be frozen since freezing may cause irreversible physical changes. • Opened powdered formulas may be stored in a closed container according to manufacturer expiration date or up to 4 weeks (30 days). The date of opening should be written on the container, and it should be stored in a cool dry area when not in use.
Hang Time of Feeding	• Canned ready to use formula and reconstituted formula must be delivered to the patient within 4 hours of preparation. • Refillable sets (bag and tubing) must be replaced at 24 hours.
Reference	1. Preparation of Formula for Infants. Guidelines for Health Care Facilities. The American Dietetic Association; 1991. 2. Olree, K., et al. The ASPEN Nutrition Support Practice Manual. ASPEN (American Society for Parenteral and Enteral Nutrition): Silver Springs, MD; 1998.