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ESSENTIAL STEPS Prompts for assessors Audit 2 Enteral feeding

Intervention

Criteria required

Standard not achieved if

Preventing the spread of infection

Hand hygiene (see reverse) Suitable method and technique used.

Refer to ES orange audit 1

Personal Protective equipment used as appropriate for the procedure (see reverse) Asepsis (see below)

Hands not washed, as over. Nail varnish, False nails, Wrist watch, wrist/ hand jewellery (exc.plain wedding band) PPE not worn as required by procedure

Preparation and storage of feeds

Administration of feeds

Feed is stored correctly as per manufactures instructions (check) Preparation of clean plastic tray – wash in hot soapy water and dry with clean cloth Preparation carried out in a clean area away from raw foods such as meat, fish, eggs, vegetables. This may be carried out by the carer/patient Check expiry date and any signs of damage to the container. Aseptic non-touch technique should be used to connect the feed container to the giving set Administration sets and feed containers are single use The feed is given over a period appropriate to the feed type.

Inappropriate storage not addressed. Tray not cleaned before preparation of feed

The stoma / site should be cleaned daily with water & thoroughly dried. This may be carried out by the carer/patient The tube should be flushed with fresh tap water (sterile or fresh boiled cooled if immunocompromised) before and after feeding or administering drugs

The site is not cleaned. Concerns re: self care not addressed with patient or carer Incorrect solution used to flush tube

Ready to use = 24 hours max hang time Reconstituted = 4 hours max hang time

Care of insertion site and feeding tube

See below

Preparation carried out in an inappropriate area or Concerns re: self care not addressed with patient or carer Expiry date and condition of feed not checked Level of asepsis is not maintained/ breaks in asepsis not addressed.

Feed not administered appropriately.


Suggested hand washing and alcohol application technique

3 Wash/rub ALL surfaces of the hands. These six steps should take about 15 seconds

Risk assessment for the use of PPE. *NB the term body fluids includes wounds. NO contact with body fluids*

No protective clothing required

Contact between clothing and patient, and or equipment (including laundry)

Disposable plastic apron

Contact with body fluids (incl. excessive skin scales) but low risk of splashing

Contact with body fluid and high risk of splashing

Disposable gloves and plastic apron

Disposable gloves, plastic apron, face protection

Risk assessment for asepsis. Aseptic technique to be used instead of a clean technique if the patient falls into any of the following categories: Babies

Immunocompromised patients

Patients with diabetes

Frail patients

Clients with chronic disease

Patients in poor nutritional state


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