4 ENFit® Implementation Challenges and How To Solve Them
Hospitals can face a number of obstacles when adopting ENFit® devices. Here are a few of the most common.
ENFit® is a system of enteral connectors and tube feeding devices designed to improve the outcomes of NICU patients by preventing misconnections. First recommended by The Joint Commission in 2008, ENFit® products adhere to ISO standard 80369-3:2016, which stipulates that the design of enteral feeding tube products must be unique and incompatible with legacy devices.
The goal of this initiative is to prevent misconnections, which occur when a medical device is mistakenly connected to a device of another type. If an enteral feeding tube is connected to an IV line, for example, it can result in severe harm or death for patients. In fact, analysis from The Joint Commission found that in 116 case studies involving misconnections, at least 21 resulted in patient death. This number is likely a conservative estimate, as many misconnections are miscategorized as medication errors.
While successfully transitioning to ENFit® is a necessary step for preventing misconnections and reducing the potential for human error, it can be challenging for procurement managers and hospital purchasing departments to make the change. Here are a few common obstacles to adopting ENFit® products and how to address them.
4 Common ENFit® Implementation Challenges
1. Knowledge Gaps
Although ENFit® connection systems are becoming the industry standard, it can be difficult for hospitals to find accessible information and the right partners for rolling out the new system. Sales representatives may not be familiar with ENFit® devices, and hospital stakeholders may not fully understand the need.
If there’s interest in adopting ENFit® products, ECRI Institute suggests beginning with an interdisciplinary approach. Personnel from a range of departments — such as biomedical, nursing, pharmacy, purchasing, risk management, technology management, and others — should work together to assess potential hazards posed by other enteral connectors and develop strategies to mitigate risk. This not only helps to identify the areas that would benefit most from the transition, but also to bring internal departments into alignment as the project gains traction.
2. New Supply Chains
Hospitals can get around some of the challenges of establishing new supply chains with methodical planning. It’s important to contact medical equipment suppliers early for information about the new ISO standards and ask how each supplier will assist during the transition.
It’s also important for facilities to have a clear sense of their demand for ENFit® connection systems, along with secondary and tertiary syringe suppliers to prevent inventory shortages. Cataloging manufacturer reference numbers that clearly indicate which products come from which suppliers, and developing contingency plans for how to respond in the event that a product is not available can help keep supply chain logistics manageable.
3. New Tools and Little Guidance
All staff who will be using or repairing ENFit® equipment must receive training from the manufacturers to ensure that the new enteral connectors are not modified in any way and used only as intended. Proper training can also help maintain clear communication between prescribers and pharmacists when discussing the administration route for medication. Reference materials should remain accessible to hospital staff after training as well.
4. Maintaining Momentum During Transition Periods
During the transitional period, when both legacy enteral connectors and ENFit® products are available, it’s critical to ensure that the older systems are actually being phased out. Facilities need to commit to only purchasing new equipment that adheres to the new ISO standard, which means no longer procuring luer lock connections for enteral supplies.
Standardizing certain practices during the rollout can also contribute to a smoother transition period. These include minimizing the use of transition adaptors, adopting high-reliability practices when tracing all lines back to their sources, and routing tubes serving different purposes in distinct, standardized directions to further limit the potential for misconnections.
Overcoming Implementation Challenges with Kentec
Transitioning to ENFit® connection systems involves many moving parts. The good news is that Kentec Medical is standing by, and our team is prepared to help procurement managers navigate the obstacles listed above and help facility managers with the process of implementing ENFit® products and safety oral enteral products in their hospitals.
At Kentec Medical, we take pride in providing unparalleled customer service — we believe it’s key to improving NICU patient outcomes and providing safer experiences for patients and healthcare staff alike. We work closely with facilities during the process of transitioning to ENFit® devices to ensure that implementations are as efficient and successful as possible.
Bagian, J. P., Frederico, F., & Barnsteiner, J. H. (2014, August 20). Managing risk during transition to new ISO tubing connector standards. Sentinel Alert Event, (53). doi:https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system-folders/assetmanager/sea_53_connectors_8_19_14_finalpdf.pdf?db=web&hash=5259E85202D5CE621294E9C46E8ED86C
ECRI Institute. (2006). Preventing Misconnections of Lines and Cables. Health Devices, 35(3), 80-95. doi:http://www.premiersafetyinstitute.org/wp-content/uploads/Preventing-Misconnections-of-Lines-and-Cables.pdf
Global Enteral Device Supplier Association Clinical Advisory Board. (2020, May 08). GEDSA Letter to the Joint Commission [Letter written May 08, 2020 to Joint Commission]. In Stay Connected. Retrieved November 17, 2020, from http://stayconnected.org/wp-content/uploads/2020/05/GEDSA-_Letter_to_the_Joint_Commission_StayConnected_20200805.pdf
ISO 80369-3:2016. (2017, November 08). Retrieved November 17, 2020, from https://www.iso.org/standard/50731.html