Page 59 - policy and procedure infection control

Policies and Procedures on Infection Control

4.4 Enteral Feeding

4.4.1 Introduction

Enteral Feeding is nutrition provided through the gastrointestinal tract, which includes
feeding given via tube and oral. Enteral Feeding preparation and formulation is very complex
and should be individualized according to patient’s disease conditions and needs.

Contaminated formulas may cause gastrointestinal complications such as diarrhea and
vomiting. Colonization of feeding tubes may cause tube occlusion and degradation while
colonization of the stomach as been associated with nosocomial infections.

Therefore, minimizing potential microbial contamination is crucial to ensure patient achieve
optimal nutrition and prevent serious infection and complications related to enteral feeding.
This will promote faster recovery rate, shorten hospital stay and reduce overall cost.

The risk of contamination occurs during preparation, administration, and storage of the
formula and the design of feeding system used. Powder or liquid concentrates prepared
on-site poses high infection risk and commercially prepared feeds are known to have
lower infectious complications. Bacterial contamination of enteral feeds most commonly
arises from exogenous sources.

4.4.2 Routes Of Feeding
1. Oral
2. Tube Feeding

a. Nasogastric
- short term feeding for 4 to 6 weeks
b. Enterostomy postpyloric
- Long term feeding for > 6 weeks
c. Gastrostomy/Duodenostomy/Jejunostomy/Percutaneous endoscopic
gastrostomy/ Percutaneous endoscopic jejunostomy
- Long term feeding

4.4.3 Causes Of Microbial Contamination And Preventive Measures

Causes of Contamination Preventive Measures

Personnel 1. Health care worker with active diarrhea should not handle
enteral formula until they have been cleared.
2. Open skin lesions should be covered to prevent potential
contamination with bacteria.

48 Ministry of Health Malaysia