Transition to ENFit Connectors Presents Opportunity to Review Feeding Tube Protocols

Jennifer E. Engen

Newswise — The transition to a new type of enteral connectors provides an opportune time for healthcare organizations to review their protocols and standards of care related to nasogastric feeding tubes.

Healthcare organizations in the United States are currently moving to adopt the new ENFit connectors that meet the International Organization for Standardization Standard 80369. Specifically designed to be different from universal connectors commonly used in healthcare, the new style of connector was developed to prevent feeding tube misconnections that occur when one type of medical device is inadvertently attached to another device.

Tracing all tubing or devices from the patient to point of origin before connecting during any transition of care or at patient hand-off is one of the best practices outlined in “Placement of Nasogastric Feeding Tube and Postinsertion Care Review.”

The in-depth journal article provides an update on the often-controversial topic of feeding tube insertion and care, with a focus on preventing complications associated with this intervention. The article is published in AACN Advanced Critical Care.

Authors are Lindsey Bloom, DNP, RN, CCRN, SCRN, critical care clinical practice specialist, Adventist Health, Roseville, California, and Maureen Seckel, MSN, RN, APRN, ACNS-BC, CCNS, CCRN, critical care clinical nurse specialist and sepsis coordinator, ChristianaCare, Newark, Delaware.

“More than a million temporary nasogastric feeding tubes are inserted every year in the United States, and variations in practice and outdated protocols can impact patient safety and lead to complications,” Bloom said. “With this article, we want to encourage standardized and up-to-date procedures to minimize risks and improve outcomes.”

Beyond the impact on individual patients, feeding tube complications related to insertion or postinsertion care are acknowledged by The Joint Commission as sentinel events and increase costs, length of stay and mortality rate.

In addition to misconnections, the article provides evidence-based recommendations to prevent other postinsertion complications, such as medical device-related pressure injuries, tube dislodgement, tube occlusion, sinusitis and aspiration.

The authors present detailed evidence about methods of insertion and recommendations on how to ensure that tubes are correctly placed and safely maintained.

“Blind tube insertion, without any visualization confirmation technique, is extremely dangerous for the patient because misplacement into an airway is not uncommon and can lead to development of a pneumothorax and death,” Seckel said. “The numbers may be low on a hospital-by-hospital case count, but as a whole, the risk is significant.”

Recommendations for postinsertion care also address enteral feedings, residuals and medication administration, as well as securing the tube and monitoring for tube migration.

The article is one of several published in the journal’s spring 2022 issue about critical illness and the gastrointestinal (GI) system. Other articles in the symposia focus on:

  • Current trends in liver transplantation
  • Acute responses to infectious and inflammatory disorders of the GI system

AACN Advanced Critical Care is a quarterly, peer-reviewed publication with in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles and columns of interest to critical and progressive care clinicians.

Access the issue by visiting the AACN Advanced Critical Care website at

About AACN Advanced Critical Care: AACN Advanced Critical Care is a quarterly, peer-reviewed publication with in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. An official publication of the American Association of Critical-Care Nurses (AACN), the journal has a circulation of 4,845 and can be accessed at

About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with more than 130,000 members and over 200 chapters in the United States.

American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000;;;

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