Open vs. Closed Feeding Systems

Summary

This video explains the differences between open and closed systems for delivering enteral nutrition. Open systems involve pouring formula into a syringe or feeding bag, which increases contamination risk but allows flexibility with smaller containers. Closed systems infuse formula directly from a sterile container, reducing contamination and labor but may be costlier. Factors influencing the choice include the available formula, feeding method, contamination risks, nutrient delivery, and cost. The video also touches on studies comparing nutrient delivery and nurse satisfaction, with most preferring the closed system for its convenience.

Takeaways

• 📦 Open systems require formula to be transferred from a container to a syringe or feeding bag before administration.
• 🔒 Closed systems allow formula to be infused directly from a sterile container, minimizing the need for handling.
• ⏳ Closed systems have a longer hang time of up to 48 hours, while open systems typically have a maximum hang time of 8 hours in medical institutions.
• 🦠 Open systems have a higher risk of contamination due to increased exposure to air and handling during the transfer process.
• 🧪 Both open and closed systems can achieve similar nutritional goals, but research suggests closed systems might slightly improve nutrient delivery.
• 💰 Closed systems are generally more expensive due to the cost of larger containers, but they save nursing time, which might offset some of the cost.
• 💼 Nurses tend to prefer closed systems due to their ease of use and lower labor demands, as indicated by surveys on nursing satisfaction.
• 📈 Studies suggest that patients using closed systems receive a higher percentage of the ordered nutrition compared to those using open systems.
• 📚 The decision to use an open or closed system can depend on factors like available formula, feeding method, risk of contamination, and cost.
• 🏥 Institutional policies and available resources often influence whether open or closed systems are used in medical settings.

Q & A

What is the main difference between an open system and a closed system in enteral nutrition?

An open system involves transferring formula from a container into a syringe or feeding bag before infusion, while a closed system delivers formula directly from a sterile container without the need to transfer it.

What factors determine whether to use an open or closed system for enteral feeding?

The choice between an open or closed system is influenced by the availability of the formula, the feeding method, the risk of contamination, nutrient delivery, cost, and the nurse's workload and satisfaction.

Why is there a higher risk of contamination with an open system?

Open systems involve more human contact and exposure to air, which increases the risk of bacterial growth once the formula is opened and transferred.

What are the recommended hang times for open and closed systems in a medical institution?

In a medical institution, open systems have a maximum hang time of 8 hours, or 4 hours if reconstituted from powder. Closed systems can hang for up to 48 hours, provided the tubing remains unchanged; otherwise, it's reduced to 24 hours.

Which system is more time-consuming for healthcare staff, and why?

Open systems are more time-consuming because staff must pour formula multiple times a day, with a hang time limit of 8 hours, compared to closed systems which only need handling once or twice a day.

How does nutrient delivery compare between open and closed systems?

Studies suggest that closed systems may offer slightly better nutrient delivery, with one study showing patients receiving 84% of the ordered volume in a closed system compared to 74% in an open system.

How does cost differ between open and closed feeding systems?

Closed systems are slightly more expensive, mainly due to the higher cost of formula per milliliter in larger containers. However, this may be offset by savings in labor costs and reduced nursing time.

Why do nurses tend to prefer closed systems over open systems?

A survey showed that 88% of nurses preferred closed systems due to their ease of use, time efficiency, and comparable waste production, making their tasks more manageable.

Why might the choice between open and closed systems be dictated by formula availability?

Not all medical institutions have both open and closed versions of the same formula available at all times, so the choice may depend on what is in stock at the time.

What impact does the feeding method have on the choice of open or closed systems?

The feeding method affects the system choice; for example, bolus feeding is better suited for open systems with smaller containers, while continuous or cyclic feeding is more practical with closed systems using larger containers.