Recommendations
69.

Use minimal handling and an aseptic technique to connect the administration system to the enteral feeding tube. [new 2012]

Relative values of different outcomesThe GDG considered diarrhoea, vomiting, peritonitis and gastrostomy site infection the most important outcomes for this question. However, no evidence was identified which reported these outcomes.
Trade off between clinical benefits and harmsThe GDG recognised the potential for contamination when assembling a feeding system. Consequently adopting an aseptic technique, in which no key parts are touched, when assembling the equipment was considered the most important practice, regardless of how this is achieved. An example of this is that no open part of the enteral feeding delivery system, feed or enteral tube should be in contact with the hands, clothes, skin or other non-disinfected surface.
Economic considerationsThe GDG did not think that adopting an aseptic technique would be associated with any additional time or resource requirements.
Quality of evidenceNo clinical or economic evidence was identified.
Other considerationsA minor change was made during the update in that the term ‘no-touch’ was removed. The GDG noted that this terminology can cause confusion. The GDG chose the term ‘aseptic technique’ as its preferred option for describing this approach. It was acknowledged that connecting the administration system to the enteral feeding tube is a procedure that should be carried out in a manner that maintains and promotes the principles of asepsis.
See also the sections on asepsis discussed in LTC (section 10.6) and VAD (section 12.3) chapters.

From: 11, Enteral feeding

Cover of Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care
Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2.
NICE Clinical Guidelines, No. 139.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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