Enteral Feeding Safety

Enteral Nutrition (EN) is the administration of nutrients directly into the gastrointestinal tract.  It is the preferred method for providing nutrition and is used when the patient’s GI tract is functional, as it is less invasive, has a lower risk for infection, and is safer than the parenteral method. Enteral nutrition also preserves the gut structure and function and is more cost effective than parenteral nutrition.  The American Society for Parenteral and Enteral Nutrition released a safe practice guideline for enteral feeding. ASPEN’s A.L.E.R.T. safety campaign outlines the 5 core steps for safely administering enteral feedings.


Aseptic Technique
  • For preparation and delivery of enteral formula
  • Practice good hand washing technique
  • Wear gloves when handling feeding tube, per facility policy and procedure
  • Avoid touching can tops, container openings, spike and spike ports


Label Enteral Equipment
  • Patient name and room number
  • Formula name and rate
  • Date and time of initiation
  • Nurse initials


Elevate HOB
  • Elevate the head of the bed when possible
  • Head elevation may mitigate the risk of reflux and aspiration of gastric content


Right Formula
Right Tube
Right Patient

  • Match the formula and rate to the patient’s feeding orders
  • Verify  that the enteral tubing set connects formula container to the feeding tube


Trace All Lines and Tubing Back to Patient
  • Avoid misconnections by tracing all line from origin to patient
  • Verify only enteral to enteral connections

Reference ASPEN – American Society for Parenteral and Enteral Nutrition:

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