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Are You Ready for ENFit? New Enteral Connectors

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist | Shield HealthCare
04/24/15  4:18 PM PST
ENfit Enteral Connectors

 Looking for the latest ENFit update? Click here.

The enteral device industry is undergoing a major change in 2015/2016. You will notice differences in the feeding sets, syringes and feeding tubes that you use over this coming year and next. These changes are referred to as ENFit.

Shield HealthCare wants to make sure that you are aware of these changes. Read on to find out more!

WHAT is ENFit?

To improve patient safety, manufacturers of enteral devices are required to change the way enteral feeding sets and syringes connect to feeding tubes. The name of the new connection is ENFit.

Enteral tubing misconnection occurs when enteral devices (feeding bags, tubes or syringes) are connected to non-enteral devices, such as IV lines, urinary catheters and ventilator tubing.

ENFit is the new connection standard, developed by an international group of clinicians, manufacturers and regulators as part of the Stay Connected initiative to prevent tubing misconnections.

WHY change?

The Joint Commission identifies tubing misconnection as a sentinel (high risk) event.

ENFit connectors will not allow accidental connection between enteral and non-enteral devices.

WHEN will this happen?

The transition from current enteral devices to ENFit will occur over three phases in 2015 and 2016.*

Each phase will include a change to a different part of the enteral feeding system.

New ENFit Enteral Connector Timeline:AENFit Phase1

And the new schedule is as follows:

First Quarter (January – March) 2016

  • Enteral-specific syringes with ENFit tip
  • Enteral Feeding tubes with ENFit connectors

Syringes new timeline

Feeidng tubes new timeline

Transitional stepped connectors and current syringes will remain available while patients make the transition to the new feeding tubes.

Please consult your supplier for product-specific availability and indications.

*All dates are projected estimates and subject to change due to timing of product-specific regulatory review and manufacturer discretion.

Here’s how Shield HealthCare is helping to increase awareness in the community about these changes:

  • Training for healthcare professionals
  • Training for Shield HealthCare staff and representatives
  • Notification letters to customers affected by these changes
  • Close communication with manufacturers

Click here for a full-size printable PDF of the postcard below: Postcard (please be advised that the dates have changed since the creation of this PDF).

ENFit postcard

For more information, visit Stay Connected 2015  for frequently asked questions and the latest updates on this initiative.

Comments

8 Comments

  1. Posted December 8, 2015 at 11:42 am PDT

    Seems more and more medical companies that stand to make a profit selling commercial formulas are jumping on the ENFit connector band wagon. Some food for thought before you place too much emphasis on ENFit being the safety solution for small bore feeding tube connectors.

    1. ENFit connectors will create another safety issue once implemented that is larger than the less than 10% misconnection issue. It’s called tube pull outs, and is a result of having the feeding tube snag on any obstruction, (I.e IV pole, door knob, chair rail, bed post, car door jam, brushing up against another person while in a crowed elevator, or walkway). Currently with the existing connector if a snag happens the feeding tube disconnects saving a feeding tube pullout. Once the ENFit connector becomes an everyday connector and is twist locked so it will not disconnect then pull outs will be happening more and more. Causing unnecessary exchanges, stoma and stoma channel damage. ER visits and RIG or PEG procedures to place new tubes. There is more safety issues if you are interested check out ENFit issues on the web.

  2. Posted December 9, 2015 at 2:20 pm PDT

    Hi Ronald,

    Thank you for voicing your concerns here. You’re not alone. Everyone is anxious about this global initiative, including end users, manufacturers and suppliers who will all have to adjust to these changes.

    By law, all enteral device manufacturers, suppliers and clinicians in the U.S. and Europe must comply with safety standards and guidelines that were developed to reduce the incidence of enteral misconnections – when enteral devices connect to non-enteral devices, such as respiratory and intravenous tubing. This was in answer to numerous adverse events and deaths being reported by organizations such as the FDA and The Joint Commission. After many years in development, the ENFit design was agreed upon by safety organizations, manufacturers and other groups and approved by the FDA. Its goal is to prevent the accidental misconnection of enteral and non-enteral devices and to improve patient safety.

    ENfit connection connects the feeding tube port to the syringe or feeding set during use. You would disconnect the syringe or pump/gravity feeding set when done feeding, flushing or administering medications so it shouldn’t stay connected and pose a risk of getting snagged on something. For many people, it should solve the issue of feeding sets becoming disconnected from the feeding tube during a feeding and as some say, “feeding the bed” in the middle of the night with leaked formula.

    Although many organizations have come together to help make the transition a smooth one, as with any change, there will be some adjustments to be made by end users, manufacturers, suppliers and clinicians.

    Please check out these resources:

    For more information, an updated timeline and a list of frequently asked questions and concerns, visit stayconnected.org

    The Oley Foundation will host and stream live the Global ENFit Summit to discuss concerns from consumers and other groups on December 11, 2015.

    Here is a good explanation of the change from a consumer perspective on Feeding Raya (note that the timeline has changed since this blog was published).

  3. Patricia Hunter
    Posted December 29, 2015 at 12:19 pm PDT

    The supplier of my enteral supplies, Lincare in Jacksonville, Florida did not inform me of upcoming changes. So, I received a supply of bags with the new connector. Finally learned after a couple of weeks about the change and had to rely on internet for informaton. This interim connector doesn’t stay connected. HATE IT!

    I am afraid of the Enfit connector because it will only cause more tube pull-outs. Wishing we users had a say before these changes were made. Had no problem with existing connectors, bags, syringes.

    Will multiple companies be providing the supplies or does one company have a monopoly…that’s what its looking like.

  4. Posted December 29, 2015 at 1:20 pm PDT

    Hi Patricia,

    Thank you for your comment and question! If you are using the Infinity pump, there have been some reported issues with connection between the white transitional stepped connector and the purple ENFit connector on the Infinity bags. Moog, the manufacturer of the pump and bags, has decided to go back to the original red stepped connectors until they can find a solution. Nestle, who distributes the pump and bags, may start shipping these out by January 2016. Feeding tubes and syringes are slated to change to ENFit during the beginning of 2016. All U.S. manufacturers, distributors, supply companies and healthcare facilities will be expected to comply with the new enteral connection. Visit stayconnected.org for more information on ENFit. The Oley Foundation has also provided some resources on the subject.

  5. Posted December 31, 2015 at 4:35 pm PDT

    The new connections seem rather small in diameter of the passage. This could be a serious problem for people like me who puree real food rather than use the corn syrup poison that is traditional PEG formula. The traditional formula destroyed my pancreas in 18 months due to sugar being the only source of calories in the formula. I started blending my own food and using a fresh food formula called Liquid Hope. Since then my glucose and A1C has been manageable (though I am still fighting it – I was never diabetic before as I was an athlete and always ate healthy). This new connection seems to solve a relatively nonexistent problem, but rather to force more people to use the traditional corn syrup formulas.

  6. Posted January 5, 2016 at 10:25 am PDT

    Hi Eric,

    Thank you for your comment! Your concern is valid and shared by others. The new ENFit feeding design standards were developed with current practice in mind and specific requirements to avoid any disruption of therapy. Blenderized formulas are not all the same and tubes vary as well. In a study conducted with Kimberly Clark feeding tubes, comparing thicker enteral formulas, applesauce and blenderized formula, the flow and pressure requirements for ENFit and catheter-tip syringes were essentially equivalent. The study concluded that if your formula goes through the catheter-tip syringe, it should go through the ENFit connector. That said, all homemade blenderized formulas are different and you should make sure that the consistency and thickness is appropriate for your feeding tube at every feeding, as well as flush well after your feeding to help prevent clogs.

    For more info on ENFit, please check out these resources:

    For more information, an updated timeline and a list of frequently asked questions and concerns, visit stayconnected.org

    The Oley Foundation recorded the Global ENFit Summit to discuss concerns from consumers and other groups on December 11, 2015.

    Here is a good explanation of the ENFit change, including diameter of the new connectors, from a consumer perspective on Feeding Raya (note that the timeline has changed since this blog was published).

  7. Bonnie Bambrough
    Posted August 29, 2016 at 5:06 pm PDT

    Who will sell nutrisafe adapter so kangaroo feeding bags are capatible with gj feeding tube ports. The new enfit will not fit in the ports.

  8. Posted September 9, 2016 at 9:31 am PDT

    Hi Bonnie, thank you for your question! Temporary transitional adaptors will be available from different manufacturers, including Vygon, AMT, Corpak and Halyard Health. These adaptors will allow you to connect ENFit feeding bags to non-ENfit feeding tubes until a new feeding tube can be placed. You can request these adaptors directly from the manufacturer, your supply company or your doctor (most likely the doctor that placed your tube). Another option is to keep the white transitional connector that comes preattached to the end of the Kangaroo feeding bag attached, connecting it directly to your feeding port. These white transitional connectors will come with feeding bags during the conversion to ENFit until everyone has ENFit feeding tubes. I hope that helps! Please feel free to email me directly at rd@shieldhealthcare.com if you still have questions.

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