SCOPE OF THIS CHAPTER

This procedure should be followed when anyone has a gastrostomy (PEG) feeding tube in situ and forms part of the infection prevention and control procedures.

RELATED CHAPTER

Infection and Communicable Disease Control Procedure.

1. Principles

Enteral feeding is necessary for people who cannot eat normally. Liquid feed is given through a fine tube that enters the body in one of three ways:

  • Through the nose into the stomach (naso-gastric feeding);
  • Directly into the stomach (gastrostomy or PEG feeding);
  • Directly into the small bowel (jejunostomy feeding).

Enteral feeding poses an increased risk of infection and care must be taken to protect people from this risk.

2. Procedural Steps

Step Action By Whom
1. Feed should be stored according to the manufacturer’s instructions. Any feed that has been improperly stored must be disposed of. Care staff
2. Hands should be cleaned thoroughly before preparing the feed or touching the equipment. Care staff
3. Equipment should be handled as little as possible. Care staff
4. The insertion site or stoma (the place where the tube enters the body) should be cleaned every day with water and dried well. Care staff
5. To prevent blockage, the enteral feeding tube should be flushed with fresh water before and after feeding or administering medication. Enteral feeding tubes for people whose immune systems are not functioning properly (who are immuno suppressed) should be flushed with either cooled freshly boiled water or sterile water. Care staff
6. Prior to connecting an administration set, hands should be washed and dried thoroughly and sterile gloves worn. Care staff
7. The administration set should be checked thoroughly to make sure packaging has not been damaged and sterility compromised. Care staff
8. Contaminated or non-sterile items should not be brought into the sterile field. Care staff
9. Minimal handling should be used to connect the administration set to the feeding tube. Care staff
10. A pack of pre-packed feed can be used for up to 24 hours in a feeding session. Feeds that have been prepared on site should not be used for more than four hours in a feeding session. Care staff
11. After each session, the bags and administration sets should be disposed of as household rubbish. Care staff