Enteral feeding initiatives have seen practice changes in recent years. You’ve no doubt heard of ENFit connectors and the Global Enteral Device Supplier Association (GEDSA) which designed them.
To really understand the practice change urgency, it’s best to be aware of GEDSA’s core goal:
“To reduce medical tubing misconnections and improve patient safety.”
GEDSA has been working to develop International Organization for Standardization (ISO) standards surrounding tubing connectors. ISO is a worldwide federation of national standards bodies – they work to prepare international standards. International organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.
GEDSA has developed the ISO Standard Stay Connected initiative for using safer connectors in medical device tubing. The name of the enteral connectors tied to this initiative is ENFit. ENFit connectors were designed with patient safety in mind, as they help to avoid misconnections.
The ENFit design is safe for pediatric and neonatal administration. The GEDSA website shares the many supporting organizations such as ASPEN, ECRI, ISMP, Joint Commission, AAMI, NPSF, Premier, Vizient and others.
How ENFit works
The main design change of the ENFit connector is that the male and female connectors are switched.
The syringe now has a female tip, and the tubing has a male tip, and both are designed to be incompatible with IV lines.
The second change feature is that the tubing is now “locking” and not a “slip tip”. Color is not mandated (common colors include orange and purple). While not mandated, it is a good practice to ensure enteral feeding lines are visibly distinguishable from medication lines.
Why is now the right time for ENFit?
The product design basis clearly addresses why to use ENFit. But you might be asking why you should change to the product now and not continue using traditional “safety” enteral products (NGT’s, syringes, extension sets)?
Enteral safety became a priority in April of 1996 when The Joint Commission published Sentinel Event Alert, Issue 36. This alert informed the medical community that tubing misconnections remained a dangerous and potentially deadly problem. In 2006 an expectant mother and her unborn baby did not survive because of a misconnected feeding tube. Eventually a 2010 article in The New York Times1 talked about a 2006 survey that revealed 16% of hospitals had experienced a tubing mix-up.
One of the most powerful GEDSA videos introduces viewers to three women who discuss their experience with tubing misconnections, and reinforces the need to change to safer connectors to enhance patient safety. The video provides more than a reminder of the safety issues faced with tubing misconnections. It is about avoiding the disastrous mistake of placing the wrong tubing into the wrong line, and the human impact it has on patients and families. I encourage everyone to watch it.
A small error in pediatric or neonatal areas can quickly lead to devastating outcomes. Moving to ENFit – tubing designed to prevent misconnections – now versus later can help to avoid negative consequences that impact patients, and even healthcare professionals involved. Our highest priority is to improve outcomes.
And if after all that, you’re still asking “Why ENFit now,” I’ll tell you: There is no better reason than saving a life.
Looking for more on this subject? Read Cleaning ENFit in the Neonatal Intensive Care Unit.
- Harris, G. (2010, August 20). S. Inaction Lets Look-Alike Tubes Kill Patients. The New York Times. Retrieved from nytimes.com