Should gtube feeding bags be rinsed between feedings?

meanmaryjean, DNP, RN · Sep 1, 2015

In my home care job and my hospital job, we just add feeds as the day/ night progresses. The bag gets changed every 24 hours. No rinsing ever happens.

JustBeachyNurse, LPN · Sep 1, 2015

Think baby bottles. Never at room temp for more than 2 hrs. Have you ever smelled a used feeding bag after four hours?

I don't know why your coworker primes into the patient as that makes no sense.

My company P&P is rinse the bag with hot water then run ~100mL hot water either on pump at highest rate or prime until the line is "dry". All the wash water is discarded. (Wet or standing formula tubing increases risk for bacterial contamination)

Next time you don't wash out the bag take a whif. It doesn't take much for milk based formula to spoil. I had a toddler end up hospitalized with a significant GI infection because the one shift didn't think it was necessary to wash out the bags as it was only a couple of hours between feeds.

JustBeachyNurse, LPN · Sep 1, 2015

In my home care job and my hospital job, we just add feeds as the day/ night progresses. The bag gets changed every 24 hours. No rinsing ever happens.

Is that continuous or intermittent such as 300 mL @ 100mL/hr q 4h?

Continuous we can add to the volume. If in warm ambient or going outside must add an ice pack as risk of spoilage increases over 75F if out >2hrs.

**NICU Guy, BSN, RN** · Sep 2, 2015

We use disposable bags for our continuous feeds. We fill the bag with enough to last 4 hrs. After the feed is done, we use a new bag.

meanmaryjean, DNP, RN · Sep 2, 2015

Continuous OR intermittent, I have never rinsed or changed a bag before 24 hours. Hospital or home care.

In the home care world, Medicaid only provides one bag per day. Never had anyone have any type of GI issue either.

Interesting....

JustBeachyNurse, LPN · Sep 2, 2015

I had one patient that insurance decided one bag every other day for a complex, fragile toddler. Continuous feeds over 22hrs. They cultured the bag after 24 hrs after the third infection requiring inpatient stay. Voila! At the 25th hour mark there's the issue. Continuous feeds that start with a new bag we can add. Ice pack if high ambient temps. Intermittent bag must be washed.

Martyyyna · Sep 3, 2015

I definitely agree that a bag needs to be rinsed/changed when there is a larger time lapse in between feedings, but in this case the longest we ever wait is 4 hours. Sometimes it is even sooner. It just bugged me because we are classroom nurses and we have so many other things to worry about other than rinsing out a disposable bag and priming it into the pt (which took her over 30min to complete) when there are other kids that need assistance. I'm just glad I'm not the only one. This was never covered in nursing school and I couldnt find any information on google so thank you fellow nurses for your responses!

JustBeachyNurse, LPN · Sep 3, 2015

I clean and prime a bag in less than 3 minutes. What is she doing that takes 30?!?!?!?!?

djh123 · Sep 3, 2015

I agree with JustBeachyNurse - I think 4 hrs. is too long. Think of leaving a shake or protein drink on the kitchen counter for 4 hours. OK, it's in a bag, so it's not exposed to the air (and therefore oxidation), but still, room temp for 4 hrs. ...

morte, LPN, LVN · Sep 3, 2015

but they are stored at room temp. can you get the prefilled bottles? some are now super preserved that they are good for 48 hours is the system is not interupted.

JustBeachyNurse, LPN · Sep 3, 2015

but they are stored at room temp. can you get the prefilled bottles? some are now super preserved that they are good for 48 hours is the system is not interupted.

I know not in home care. We're lucky we get enough supplies for 30days