Administration Methods
The method of administration only tolerated gastrically, as opposed to small bowel
Bolus feedings
Inability to swallow, possibly following a stroke
Dysphagia
It may not actually be the most beneficial, but consider this if you are the hospital administration, or home patient
Cost
10-20 mL/hr
Trophic/Trickle tube feeding rate
Limited hang time / increased risk of touch contamination
Open System
Tube feeding is delivered by a feeding pump over 24 hours
Continuous
Most likely an indication for enteral nutrition via small bowel feedings
Intubation for mechanical ventilation
Risk of obtaining enteral access
Complications during tube placement
Maximum feeding rate for a small bowel feeding tube
125 mL/hr
Increased waste d/t cycle feeds, partial support, product change
Closed System
Intermittent, gravity drip, and bolus feedings are best tolerated by
Stable, non critically-ill patients
Patients with inadequate or expected inadequate oral intake for ___ days
>7
GI intolerance, Microbial contamination, Tubing misconnections
Complications from EN
The tube feeding order may not include the rate
Volume based orders
Allows for water addition in a home setting
Open System
Method of administration lasting 30-60 minutes
Gravity feedings
Need to feed the gut _____ to an obstruction or high-output fistula
Distal
2 benefits of keeping the mucosal barrier intact
Limiting bacterial transloaction
Reducing infectious complications
The result of holding feedings for procedures or high gastric residuals
Inadequate volumes
Closed system nickname
Ready to Hang
Used to promote PO intake and/or allow more freedom for the patient to be away from a feeding pump
Cycled feedings
Our mantra
"If the gut works, use it!"
Keeps mucosal barrier intact
Stimulates villi growth
Promotes immune function
Maintains gut integrity
The delayed orders, slow advancement to goal, and extended trophic/trickle rates are examples of
Challenges to delivering enteral nutrition
Delivery system used most often in the hospital setting, specifically in the ICUs
Closed System/Ready to Hang