Patchell C J, Anderton A, Holden C, MacDonald A, George R H, Booth I W
Children's Hospital, Birmingham.
Arch Dis Child. 1998 Feb;78(2):166-8. doi: 10.1136/adc.78.2.166.
It has previously been shown that microbial contamination of enteral feeds given to children in hospital and at home is common. This study therefore examined the effects of improvements in the enteral feeding protocol, coupled with an intensive staff training programme, on bacterial contamination.
The enteral feeding protocol was modified by: priming the feeding set on an alcohol treated metal tray, spraying the bottle opener and top with 70% alcohol, wearing non-sterile disposable gloves, and filling the feeding reservoir with feed for up to 24 hours' use rather than only four hours. Daily feeds samples were collected from 16 inpatients and home patients on enteral nutrition at the start and end of feeding. Seventy seven samples were cultured. Results were compared with previously published control data.
Enteral feed contamination rates were reduced significantly from 62% to 6% of feeds given at home (p < 0.001), and from 45% to 4% of feeds given in hospital (p < 0.001).
This study highlights the importance of using an appropriate enteral feeding protocol, and of regular staff training in reducing contamination rates of enteral feeds to an acceptable level.
此前已有研究表明，医院和家庭中给予儿童的肠内营养制剂受到微生物污染的情况很常见。因此，本研究探讨了改进肠内营养方案并结合强化员工培训计划对细菌污染的影响。
通过以下方式修改肠内营养方案：在经过酒精处理的金属托盘上准备喂养装置，用70%酒精喷洒开瓶器和瓶盖，佩戴非无菌一次性手套，将喂养容器装满可供24小时使用的营养液而非仅4小时的量。在喂养开始和结束时，从16名接受肠内营养的住院患者和家庭患者中每日采集喂养样本。共培养了77个样本。将结果与先前发表的对照数据进行比较。
家庭喂养的肠内营养制剂污染率从62%显著降低至6%（p<0.001），医院喂养的污染率从45%显著降低至4%（p<0.001）。
本研究强调了采用适当的肠内营养方案以及定期对员工进行培训对于将肠内营养制剂污染率降低至可接受水平的重要性。
