extension feeding tube use

[luvmyboys]

Hi,

Quick question regarding the extension tubing that attaches to an indwelling NG tube. The NG tube can be left in for up to 30 days per the manufacturer although they rarely last that long. We currently use one extension tube per shift but our CNS recommeded using one per feed which seems wasteful since we flush them between feeds. Just wanted to see what was happening in the NICU community - and if anyone has any available research that would be great too! Thanks!

[umcRN, BSN, RN]

One per feed here, we don't flush them either, just disconnect and take down with each feed

[luvmyboys]

Thanks for the reply. It just seems strange to me that it would need to be changed that often when the tube actually going into the patient is used for so much longer. We also use our kangaroon bags for 24 hours and rinse every four. Some nurses choose to hang a new kangaroo bag every shift (12 hours). I'm all for policy changes that protect the patient but also would like to protect the environment if there is no real evidence that it is necessary. Surely the manufacturer would like them changed every feed!

thanks again,

Julie

[umcRN, BSN, RN]

I would have to agree that it's pretty wasteful, we also change all our bags/tubes with every feeding as well. Definitely no rinsing/reusing here.

[NICU_babyRN, BSN, RN]

Our policy is to actually change the tubes every 7 days! We used to use the tubes for 30 days but found we were having a higher incidence of NEC. We discard all syringes and extension tubing after each feed as well.

[BittyBabyGrower, MSN, RN]

Syringes get changed every feed, tubing is good for 4 hours. We use the 30 day tubes and haven't seen an increase in NEC.

[cindee7]

our policy in the nicu where I work is to use a new extension feeding tube with each feeding. Seems wasteful to me as well. Flushing with sterile water after each feeding and using the extension tube for an 8 hr shift is something we used to do. I'm not sure why its changed. Perhaps nicu is following manufacturers recomendations (manufacturers playing it safe)

[dixRN]

As a traveller I have worked 8 NICUs in the past three years & all 8 changed their breast milk tubing at the maximum every four hours, some every feeding. Their policies on tubing used with formula varied from changing every feeding to every eight hours.

[Eyeknit, ADN, BSN]

My experience - extension tubing every feed or at a max every four hrs. NG/OG tube was silastic, changed every 30 days per manufac. guidelines. Haven't worked anywhere yet that discriminated between breastmilk and formula although as a nurse I know that formula was more prone to clog the tubing . . . . so it makes sense to change it more frequently.

[NeoNurseTX, RN]

Syringes get changed every feed, tubing is good for 4 hours. We use the 30 day tubes and haven't seen an increase in NEC.

Same on my unit. And Kangaroo bags are changed q4h if it's continuous and with every feed if they're on bolus. However, when they go home, they get a bag a day or something of the sort... ??

[umcRN, BSN, RN]

My experience - extension tubing every feed or at a max every four hrs. NG/OG tube was silastic, changed every 30 days per manufac. guidelines. Haven't worked anywhere yet that discriminated between breastmilk and formula although as a nurse I know that formula was more prone to clog the tubing . . . . so it makes sense to change it more frequently.

My hospital has no policy on changing the actual tubes so I'm wondering...what about NJ tubes? Do you change those every month too? Sometimes it's so hard to get those things in we keep them as long as we possibly can and I know I've taken care of kiddos who had them longer than a month.