How to Use the Infinity Pump ENFit Transitional Connector

6 Comments

1. 
   Barb Davis

   Posted September 21, 2015 at 6:04 pm PDT

   The new ENFit connector with adapter is worthless. In one week, we have had 3 leaks. The adapter is worthless. Don’t think the change was necessary but then I have never liked the bags with cassettes. I’ve been doing this for 16 years. Making changes without consulting people who use this product daily – is very poor designing.

   The new connectors and the syringes should have come out with the new bags. All much more time consuming and at 4x a day – crazy!

   Will be looking for another pump, products, etc.

2. 
   Amy Carrera, MS, RD, CNSC

   Posted September 22, 2015 at 8:48 am PDT

   Hello Barb,
   I’m sorry you are having this experience. When the FDA and other organizations and manufacturers made the plan to change the design of enteral devices they had patient safety top of mind. As with any large-scale change, however, it’s been a tough adjustment for patients and health care providers alike. The original plan was for bags, syringes and feeding tubes to make the transition in 2015 but the timeline got delayed by some syringe issues related to safe delivery of small-dose medications. Manufacturers worked together to address the issue and syringes and feeding tubes are slated to transition to ENFit in January 2016.

   In regards to the leaking, I wish it were as easy as changing pumps but unfortunately, all pump and bag manufactures are currently providing bags with both the ENFit connector and transitional stepped, or “Christmas tree” adapter. Nestle has provided tips for optimal use of the Infinity bags, such as making sure the stepped connector is twisted snugly (but not too tight) into the purple ENFit connector and cleaning and drying the connectors before use. There may be additional adapters that will help with the leaking, depending on what you are currently using. Ask your home supply company about trying an adapter. If the leaking is occurring between the feeding port and the white transitional stepped connector, an adapter may help.

   The goal of the change is to prevent additional deaths and near-misses that may result from connection of enteral and non-enteral devices, such as respiratory tubing and urinary catheters. The new connectors will be incompatible with these types of devices. While most of these mishaps have occurred in health care facilities, it is important that enteral devices used in hospitals are the same as those at home in order to ensure continuity of care. I know it’s frustrating but the end goal is important to patients everywhere. Your feedback is crucial to making the transition as smooth as possible so please keep it coming! And please email rd@shieldhealthcare.com if you would like to discuss further.

3. 
   Michelle Wallace

   Posted October 17, 2016 at 10:47 pm PDT

   We got a shipment of White tips this month and I can definitely say I’m not satisfied. We feed a Blenderized Diet to my daughter and even after modifying the bag it CLOGS every hour during the night unlike the red tips. It’s the same spot on the bags every night it clogs so it’s definitely some form of difference compared to the red tips that never clogged. I’m exhausted and definitely tired of my daughter not getting her full feed.

4. 
   Amy Long Carrera, MS, RD, CNSC, CWCMS

   Posted October 18, 2016 at 8:51 am PDT

   Hi Michelle, this has been a concern of both consumers and clinicians. Some studies have been done to test the flow of blenderized formula through the ENFit system but I don’t know of any testing through the transitional connector. I am told the inner diameter does not change. Are you blending your own formula or using a commercially prepared blenderized formula? If you are blending your own the trick is to get it to a uniform consistency throughout. This takes a powerful blender – if you don’t already have one you may be able to get help obtaining one through your insurance. That said, at some point in the next few months, feeding tubes and extension sets will have the ENFit connection so you won’t need to use the white transitional connector. The timing of this depends on your supply company and/or local children’s hospital. That is, if your local children’s hospital or the GI clinic is starting to place ENFit tubes and use ENFit syringes, your supply company may decide to start carrying them. You might try asking either of them what their plans are for ENFit.

5. 
   R Balius

   Posted January 23, 2018 at 2:37 pm PDT

   Since we got these new bags, we’ve had two instances of the purple connector disconnecting from the transitional connector in the absence of any force. The resulting mess causes a lot of discomfort for the PT, and a lot of extra work for caregivers. After the first disconnect happened, we read the website page and have been tightening these as we use them. The second disconnect happened this morning after we had hand-tightened the connection. A few suggestions: 1) In checking connectors, it’s clear that they are not being tightened very well at the factory. It’s a lot to ask of the end user to tighten a connection that might reasonably be considered to be delivered tight and leak-free. Perhaps the transitional connector could either be delivered disconnected, or it could be properly tightened at the factory. 2) The connector only turns 1/4 to 1/2 of a turn and has a pretty aggressive thread pitch. This is not a recipe for a failure-proof connection. Is there some kind of locking tab, clip or detent that could be incorporated into the connector design to prevent it from backing off unintentionally? 3) The rollout of this feature has been poorly executed, as Zevex is, no doubt, aware. Given the miscalculations that were made and the attendant inconveniences to the end user, wouldn’t it make sense to be especially careful that this “transitional” connector (which will, it seems, be in use for quite a long time, if not indefinitely) is usable, secure and not failure-prone? For a lot of us you’re solving a problem that doesn’t exist by adding another failure-point in an already complex system.

6. 
   Amy Long Carrera, MS, RD, CNSC, CWCMS

   Posted January 24, 2018 at 8:08 am PDT

   Sorry you’re having trouble. The manufacturer is aware of the issue. Are you using a g-button tube with an extension set? The good news is, that if you get your supplies from Shield HealthCare, you may start to see ENFit extension sets as early as February. This way, you can ditch the transitional connector. If you get your supplies from another provider, you might check with them to see when they plan to offer ENFit supplies. If you have a standard gastrostomy tube, the conversion to ENFit may take a little longer, as the product is not yet available from all manufacturers. In addition, your doctor may want to wait until its time to change the tube. Thank you for your comments!

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