Enteral tube feeding, also known as Clinically Assisted Nutrition, is a form of medical treatment and involves the administration of specialised nutrition and fluids via a tube into part of the gastrointestinal tract in patients who are unable to take any nutrition orally or are unable to meet their full nutritional requirements orally.
This policy is designed for use by all healthcare professionals involved with adult enteral tube feeding throughout the Trust. It aims to provide evidence based guidance to all staff involved in adult enteral tube feeding with the goal of minimising the potential risks and complications of enteral tube feeding, standardising practice and ensuring compliance with the relevant patient safety alerts and national documentation.
There are several types of enteral tube used for adult patients at ASPH and the choice will depend on a range of factors including patients indication for enteral tube feeding, clinical condition and length of time tube feeding may be required. This policy explains how these choices may be derived. The policy does not cover nasogastric feeding which is covered in the Nasogastric Tube Feeding Policy.
This policy also covers considerations for decision making in line with national guidance, the indications and contraindications for each method of enteral tube feeding, goals, assessment and safe discharge planning. It also contains principles of care and a troubleshooting section.
Enteral tube feeding is not an emergency and should be carefully considered with clear documentation explaining decision making and careful monitoring in order to prevent, detect and manage complications (NICE 2006, reviewed 2019). The ethical and legal implications need careful consideration and these are best considered as part of a multidisciplinary team (MDT). This policy outlines the roles and responsibilities of the MDT for each part of the tube feeding pathway.
- Parenteral Nutrition Policy
- Insertion of nasogastric tube policy (in draft)
- Nasal retention device (nasal bridle) policy
- Consent Policy
- Protocol for establishing enteral feeding in Intensive Care
- Mental Capacity Policy
- Use of Mittens Policy
- Nutritional and Hydration Risk core care plan
- Initial PEG insertion core care plan
- Patient has a PEG tube care plan
- Initial RIG (balloon gastrostomy) core care plan
- Patient has a balloon gastrostomy care plan
- Care of patients with Nasogastric or orogastric tubes core care plan
- Care of adult patient with a nasojejunal tube core care plan
- Care of nasotube retention device care plan
- Care of PEG competency
- Care of surgical jejunostomy careplan
- Insertion of fine bore feeding tube competency
- ROADMAP tool