Help with bolus enteral feedings

[nocangel2]

I am rewriting our policy regarding enteral feedings, and I am wondering what you all have as the maximum use time for feeding bags and tubing. I am primarily interested in bolus feedings. Does anyone toss after every bolus? Right now the policy is rinse and reuse for 24hrs. Any articles I can find have been conflicting about infection rates, hang times etc. Appreciate your input!

[mrsbrittLPN]

I have never done the "rinse and reuse", our facility policy has always been to change all bags,bottles,tubing after 24hours, although the manufactor recommends every 48 hours on bottles/bags. I think if it is buget concerns, "rinse and reuse for 24 hours", would probably be ok, depending on the whether or not the bag sat "off"(not running) for any length of time. I like every 24hours better....It just gives me a piece of mind that everything was replaced, new, less risk for bacteria/infection concerns. Just my personal opinion.

[NotReady4PrimeTime, RN]

We rarely do bolus feeds in our unit. The vast majority of our kids are on continuous nasojejunal feeds, so the question doesn't arise. The tubing is just changed q24 hours and that's that. But when we do have a bolus feeder (usually a child with chronic health issues) we rinse (well), close and recap and reuse for the same 24 hours. They're used to that practice at home where the parents are not going to replace the feeding bag every feed, it just costs too much!

[nocangel2]

we rinse (well), close and recap and reuse for the same 24 hours. They're used to that practice at home where the parents are not going to replace the feeding bag every feed, it just costs too much!

That is our present practice as well. The research I have been reviewing in most cases suggests that this is fine. One or two however have indicated that most infection is cased by retrograde flow and that the bacteria may not be removed by just rinsing. Since most of our bolus pts are either NICU graduates working up on feeds or kids with chronic GI issues, they would be the vulnerable population likely to come up with a rare case like that. So, just looking for some other hospital policies for consensus. Thanks!

[wanttobeanavynurse]

The unit I work on has a lot of kids with bolus feeds. We rinse and reuse bags for 24 hrs, and we make sure formula doesn't sit in the bag for very long. For continuous feeds, we only put 4hrs worth of formula in the bag at a time, and the bags are changed every 24hrs.