Should gtube feeding bags be rinsed between feedings?

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Hello fellow lovely nurses!

I got into an argument with a co worker the other day. This pt has two gtube feedings; one at 1000 and one at 1400. Normally I will run the pts feeding and leave the bag alone after it is done infusing. Then I add the other can to the bag and let that infuse. I always flush the actual gtube with water to hydrate the pt, as prescribed. The nurse I work with mixes water into the feeding bag when it is done and primes the mixture into the pt. She told me I was putting the pt in danger by not rinsing out the bag, but I really don't think it's necessary to clean the bag in between if it's only 4 hrs. At my home health case I sometimes will put all the cans for the day in one feeding bag and put it on an ice pack. What do you think?

Just to be sure you might review your company policy on that to see what the recommendation is.

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Why is she pausing the feeding pump every time she walks away? Thats seems dumb. Whats her reason?

I was wondering the same thing. If she had multiple patients (hello nursing home ratios) this poor patient would go hungry😞

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Specializes in Peds Med/Surg; Peds Skilled Nursing.

What I use to do was if it was continuous feeds I would change the bag every 24 hours. If it was bolus feeds I would put up a new bag with each bolus and throw the old one out.

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Specializes in NICU.

In the NICU, we change the bag every 24h and we don't rinse them out between bolus feeds. As far as I know, this has never been an issue.

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Specializes in Pediatrics.

My agency has instructed us that we need to

a) Change the feeding bag every 24 hours and

b) Rinse the feeding bag out between feeds.

Almost every feeding pump I use says to disconnect the pump from the patient before priming it.

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Contamination is your #1 complication with enteral feeds.

You need to check to see what the enteral formula says is the maximum hang time. Your start time is going to be when the mixture is reconstituted or the seal is broken.

There is no "standard" answer to the question. It depends on if you are feeding an adult, child, or infant. Are you using premixed formula or are you reconstituting it? If you are reconstituting it, are you using sterile water? Are you using an open or closed system?

I have attached a document that contains references and you can search by keyword for the information that you seek.

I skimmed over the article and while it mentioned flushing, it doesn't mention rinsing, it does appear that the system should be completely changed out every 24 hours. But it doesn't look like anything should be hung longer than 12...and even less, depending on the factors above.

https://www.ismp.org/tools/articles/ASPEN.pdf

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I have always thought of it that rinsing won't hurt anything but not rinsing could so just rinse. If I wouldn't drink out of a dirty cup after several hours why would I use a dirty unrinsed bag after several hours.

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Specializes in Oncology.

I always rinsed the bag at the end of the feed. I wouldn't want to drink something that sat out at room temp for 4 hours. If you don't rinse you are giving your patient old feeding unless it is in one of those sealed containers that last for x number of hours.

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Specializes in Pedi.
because you can't compare "milk" to the canned liquid we feed by GT.

You've never seen a child on feeds that are PO + GT? It's not a different formula, what isn't consumed orally goes down the tube. Virtually every formula my patients are on by G-tube are consumed orally as well- enfamil, similac, neosure, elecare, Pediasure, Ensure, Boost. Not to mention the babies who get breast milk via GT.

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Specializes in Pedi.
What I use to do was if it was continuous feeds I would change the bag every 24 hours. If it was bolus feeds I would put up a new bag with each bolus and throw the old one out.

Insurance companies typically only pay for one/day. Some kids are on 6+ bolus feeds/day. Families would run out of bags in less than a week if they did this!

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Specializes in Oncology.

I should have said once every 24 hours I would change the bag. I totally screwed up my answer. I did rinse at the end of a feeding, then add new formula for the new if the 24 hour tubing change was due. We also used baby bottles for feedings of small amounts so much easier just to hang a new bottle, but rinse the tubing.

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