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Juliet Glassroth

(301) 461-4675





Organization Seeks to Optimize Patient Safety and Effectiveness


February 2, 2009, New Orleans, LA – The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) released the The Enteral Nutrition Practice Recommendations today at Clinical Nutrition Week, the annual meeting of clinicians, researchers and educators. These guidelines were developed to compile the best clinical practices for Enteral Nutrition (EN) and disseminate overall patient safety strategies.


In order to aggregate the optimal practices of administering Enteral Nutrition (EN), A.S.P.E.N. established a task force to examine available literature related to its ordering, preparation, delivery, and monitoring. The group’s mandate also included aggregating expert opinion - based on current knowledge and best practices - to formulate evidence-based recommendations. 


After two years of research and analysis, the task force completed The Enteral Nutrition Practice Recommendations.  Specific topics covered in the document include:

  • Ordering and labeling of enteral nutrition                    
  • Enteral formula (medical foods) and infant formula regulation  
  • Water and enteral formula safety and stability
  • Enteral access                                                               
  • Enteral nutrition administration                                                 
  • Medication administration                                                                                            
  • Monitoring enteral nutrition administration      


Sometimes referred to as “tube feeding,” EN is the delivery of food directly into the gastrointestinal tract (GI) through a tube placed in the nose, the stomach or the small intestines. It is often provided when a person cannot eat enough food due to illness; has a decreased appetite, difficulties in swallowing, or; has had surgery that interferes with eating.


The complexities of modern healthcare, compounded with decreased staff both at the bedside and at the nutrition support level, have led to the potential for an increase in risks related to EN. Complications can occur throughout the process of ordering, administering, and monitoring nutrition, compromising a patient’s safety. When not properly administered serious harm - and even death - can result from improper EN. 


“In order for complications in EN to decrease, areas for possible human error, as well as administrative and organizational conditions which can lead to mistakes, have to be clearly identified,” explained Kelly Tappenden, A.S.P.E.N. president.


Recent reports from oversight organizations including the Food and Drug Administration, the Emergency Care Research Institute and the Institute for Safe Medication Practices point out that EN misconnection errors occur with significant frequency and can lead to deadly consequences. Adverse events related to EN include misconnections, enteral access device (e.g. feeding tube) misplacements/displacements, metabolic abnormalities, mechanical tube complications, aspiration, formula contamination, and harmful drug/nutrient interactions. In fact, The Joint Commission released a Sentinel Event Alert – updates on unexpected occurrences involving death or serious injury - which identified tubing misconnections as a persistent and potentially deadly occurrence which often goes unreported.


 “Best practices in EN require a comprehensive understanding by healthcare practitioners and changes to clinical and organizational processes,” said Peggi Guenter, director for clinical practice, advocacy, and research affairs for A.S.P.E.N. “That makes Cinical Nutrition Week the optimal place to share this information – all the relevant groups needed to effect change are right here.”


The complete Enteral Nutrition Practice Recommendations can be found at


The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of nutrition support therapy.  Founded in 1976, A.S.P.E.N. is an interdisciplinary organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With more than 5,500 members from around the world, A.S.P.E.N. is a community of dietitians, nurses, pharmacists, physicians, scientists, students and other health professionals from every facet of nutrition support clinical practice, research and education. 

For more information about A.S.P.E.N., please visit


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