Nebraska Medicine will convert to ENFit-compatible enteral supplies on Oct. 13. ENFit, a connection-specific to enteral feeding systems, was introduced globally to address safety concerns related to misconnections and disconnections. Eventually, ENFit will become a standard of care nationally and internationally.
Conversion discussions began in December 2019, which included subject matter experts representing nursing, nutrition, pharmacy, physicians, purchasing and product stream. Vendor selection meetings gave the project team members the hands-on opportunity to evaluate supplies and ask questions related to their area of expertise. The two vendors chosen also were vetted by senior leadership.
Since then, product conversion efforts have been ongoing. Workflow and education development, physician engagement, and policy revision and creation followed. Finally, community health care partners were informed of the conversion to ensure patient continuity of care post-discharge.
“I am excited about this change,” said Corrigan McBride, MD, professor of general surgery. “As a surgeon who puts in a lot of feeding tubes, I have unfortunately seen many safety near misses and events because the wrong syringe was used with the balloon or in the wrong lumen. This re-design by all the manufacturers will make enteral feedings and medications administration safer.”
The conversion will take place on Oct. 13 when all legacy products will be removed from the supply chain and replaced with ENFit versions. All unused legacy supplies will be donated to the ISSA Trust Foundation, where they will be used to help patients and health care workers in Jamaica.
Along with this change, adult enteral tube feedings will be moved to the MAR for nurse documentation. In order to further increase patient safety, this change will allow nurses to barcode scan adult enteral nutrition products upon administration helping ensure the correct patient is chosen and the correct product is being administered.
Beginning Oct. 13, adult enteral tube feedings will be ordered using the newly created “General Adult Tube Feedings Focused” order set which will replace the current “Adult enteral nutrition” panel. The tube feeding orders will be medication records allowing them to show up on the MAR in a newly constructed “Nutrition” tab.
The adult tube feeding orders will also appear on the “All” tab and either the “Continuous” or “Scheduled” tab depending on their ordered frequency. The new orders will further be found in the Medications section of Manage Orders instead of the Diet section and in the Medications tab of Chart Review. Patient self-administered products such as Ensure or Boost will not be included in this update.