临床肠内营养使用安全_护理.ppt

把肠内营养输到静脉的现象，国内外均有报道。 临床病例分享（输注连接错误） 加强肠内营养管理,避免严重并发症 正确方法 错误方法 Feeding tube connected to tracheal tube IV tubing connected to feeding tube Feeding tube connected to ventilator in-line suction catheter Urological catheter connected to feeding tube Source FDA: Safe medical device connections save lives, USA 肠内营养输注连接错误 The major risk in enteral misconnection is the connection of a Luer syringe filled with enteral nutrition to a IV catheter. This misconnection could be lethal for the patient. 主要连接风险是把肠内营养输注到静脉中，从而导致病人的死亡。 ASPEN指南（3） ASPEN指南（4） When making a reconnection, practitioners should routinely trace lines back to their origins and then ensure that they are secure. Route tubes and catheters that have different purposes in unique and standardized directions (eg, IV lines should be routed toward the patient’s head, and enteric lines should be routed toward the feet). (C) 如果重新连接，操作者应该顺着输注管道到根部，确保安全。同时，不同用途的管道应该有唯一和标准性的方向。（比如，静脉管道应该冲向病人的头部，肠内管道应该冲向病人的脚）（C） Identify and confirm the EN label, because a 3-in-1 PN admixture can appear similar to an EN formulation bag. Label the bags with large, bold statements such as “WARNING! For Enteral Use Only—NOT for IV Use.”(C) 识别并且确认的EN的标志，因为三腔袋的外观与肠内营养的袋子有些类似。标志应该用大的、粗的字体。例如：“警告！肠内营养专用，不是静脉”。（C） ASPEN指南（5） Avoid buying enteral equipment that can mate with female luer connectors. Evaluate the need for and reduce the purchases of adapters and connectors that can be modified to make enteral feeding sets compatible with female luer connectors. (C) 避免购买能够与静脉接头匹配的肠内营养的输注管道，评估并且降低购买那种修改后能够与静脉连接的肠内营养输注接头。（C ） Ensure that hospital purchasing policies mandate buying only enteral feeding sets that are compliant with American National Standards Institute/Association for the Advancement of Medical Instrumentation (ANSI/AAMI) standard ID54, which effectively excludes any that are compatible with female luer connectors. These devices must also be clearly labeled (eg, “Not for IV Use”). (C) 确保医院的购买肠内营养器械的政策符合ANSI或AAMI, 排除