Should gtube feeding bags be rinsed between feedings?

[Martyyyna]

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?

[phillycpnp-pc, MSN, RN, NP]

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!

I was talking about inpatient peds not homecare.

[ambr46]

I think with an intermittent feeding rinsing would be practical but continuous just let it run it's course and change the whole setup daily

[KelRN215, BSN, RN]

I was talking about inpatient peds not homecare.

When I worked inpatient we also only changed the bag q 24 hrs.

[rn4lyfe08]

I have worked as a tech in a pedi rehab (lots of tube feedings),and as a nurse in gen peds, pedi rehab, and PICU, as well as pedi home health. Across multiple facilities/states, the policy has always been the same..hang time no longer than 4hrs, rinse bag, flush extension tubing, change bag Q24hrs. Continuous feeds are added to the bag approx 4hrs at a time. If you have a large flush ordered (one u can't quickly push or bolus), you can give it via pump before rinsing the bag so you can attend to another task. But even after that flush, you'll notice a little of the cloudy liquid left at the base of the bag (especially depending on any additives). This needs to be rinsed out of the bag to reduce the amt of bacteria that can grow in it. On older pump models, priming was fast, but newer models require priming over the pump which adds time. However, this process shouldn't take more than a few minutes to complete.

As for the other nurse pausing the pump every time she walks away, I have no answer.

But lots of places have different policies/procedures. I would check that if possible.

[Katevying13]

According to Gastrostomy feeding tube - pump - child: MedlinePlus Medical Encyclopedia

When the feeding is done, your nurse may recommend that you add water to the bag and let the water flow through the feeding set to rinse it out.

For a G-tube, clamp the tube and close the roller clamp before disconnecting the feeding set from the G-tube. For a button, close the clamp on the feeding set, disconnect the extension set from the button, and closet the flap on the button.

The feeding bag should be changed every 24 hours. Food (formula) should not be left in the bag for more than 4 hours. So, only put 4 hours (or less) worth of food in the feeding bag at a time.

All of the equipment can be cleaned with warm, soapy water and hung to dry.