What is ENFit and how is it used with enteral feeding products?

SITUATION: 

This QuickHit was informed by the hospital wide change of all enteral feeding tubes and supplies to the ENFit design in 2023 at SickKids.

BACKGROUND: 

Many children with medical complexity rely on enteral feeding tubes to support nutrition, hydration, and/or medication administration, including nasogastric and gastrostomy tubes.

ENFit refers to the global standard design for the end connectors of all enteral feeding tubes and supplies as shown below.

The ENfit design requires you to twist to connect an enteral feeding tube with an accessory. It has been designed to ensure that enteral tubes and accessories cannot be connected to other medical devices to prevent serious safety events.

ASSESSMENT: 

All enteral tubes and enteral feeding supplies (e.g. feeding bags, syringes, medication syringes) at SickKids have the ENFIt design. Many enteral feeding product manufactures, hospitals, and home and community care organizations have adpoted this global standard.

The following images demonstrate several ENFit enteral feeding tubes and supplies used at SickKids and the home and community care settings.

Feeding Tubes

Feeding Bags

Syringes

There are also accessories which can support your use of ENFit tubes and supplies as shown below. See the recommendation section for when to use these accessories.

RECOMMENDATION: 

Connected Care recommends the following when using ENFit enteral tubes supplies for children in home and community settings:

When connecting ENFit products, complete a small clockwise turn (approx. ¼ turn). Avoid overtightening connections as this can make it difficult to disconnect. Always disconnect from the patient’s enteral feeding tube after each use.
The ‘moat’ or the open area of the end of the feeding tube can collect excess feeds, medication, and debris (see image below). Use an interdental tool, soft bristle toothbrush or ENFit cleaning brush to clean daily or more frequently as needed. Watch this video with step by step instructions.

Medications prepared with ENFit syringes are drawn up using an ENFit bottle adaptor or straw. This reduces the risk of contamination and the amount of medication that collects in the moat of the syringe.

Refrain from over priming feeding bags to avoid accumulation of feed in the moat of the feeding tube.
If required, ENFit products (e.g. syringes) can be connected to non-ENFit products using an ENFit transition connector