Preparing for ENFit Conversion

Sunday, June 28, 2020

Preparing for ENFit Conversion
Stacie Ethington MSN, RN-BC
Medication Safety Nurse Specialist
Nebraska Medicine

Outcomes of tubing misconnections are well documented in the Joint Commission’s Sentinel Event Alert from August 2014. Last summer, the Global Enteral Device Supplier Association (GEDSA) released a position statement outlining the ENFit connector conversion schedule for the United States. Manufacturing of legacy devices was planned to be phased out beginning July 1, 2020, with transition adapters no longer manufactured beginning January 1, 2021. However, as a result of the COVID-19 pandemic, GEDSA recently announced that member manufacturers will continue to support customers as needed. GEDSA’s strong recommendation is for healthcare entities to contact your specific manufacturer or supplier for information about phasing out the manufacturing of legacy feeding tubes, administration sets, and transition adapters. Manufacturers’ inventories will be used up until ISO compliant inventory becomes available.

As hospitals across Nebraska continue to prepare for this conversion, the Nebraska Medicine Medication Safety Nurse Specialist, Stacie Ethington, MSN, RN-BC has submitted this article in the hopes that others can benefit from the steps she and her team are taking to successfully achieve a safe conversion in the coming months. If your organization has not yet converted, there are several resources available. GEDSA’s website has many excellent articles, presentations, and tools.  

An important first step was developing a project team that included representation from project management, nursing, nutrition, pharmacy, physicians, purchasing, and the product stream. Identified individuals, who participated in vendor selection meetings, met with possible vendors over the course of several days. This gave end-users the opportunity to get their hands on the equipment and ask questions related to their areas of expertise. Five total vendors were reviewed. The group discussed the pros and cons of each vendor, selected vendors were vetted through senior leadership. With their approval, product conversion planning began. The activities that followed included workflow development with the completion of a Failure Mode Effects Analysis (FMEA), policy revision and creation, physician engagement, education development. A major lesson learned during our project was that the enteral pumps in the Neonatal Intensive Care Unit were not compatible with the vendor that was chosen for disposable supplies. That led the team down an unexpected path of needing to get updated enteral pumps within the project timeframe. The COVID-19 pandemic did have some impact to the project, but it has only delayed the go-live by a few weeks. The targeted go-live of ENFit implementation at Nebraska Medicine is Fall 2020.

Several implications for transitions of care have been identified that hospital leaders should consider as they make this conversion. During this time transition, patients and their family members caregivers may experience variability in enteral access devices requiring ENFit adaptors and connectors. Should a patient with an ENFit enteral tube present to an organization that does not have ENFit supplies, the caregivers will not be able to access the enteral tube. If a patient with a legacy enteral tube arrives to an organization that has converted to the ENFit devices, an adaptor can be placed on the ENFit syringe or tubing set so that the enteral tube can be accessed <see transition checklist here>. In February 2020, Nebraska Medicine sent out letters to many of its community healthcare partners regarding their intent to convert to ENFit later in 2020. Within that letter, resources were shared for those that had not had exposure to the initiative. If your organization has not yet converted, there are several resources available. GEDSA’s website has many excellent articles, presentations, and tools.  Many of the enteral device suppliers have resources on their websites as well. Another invaluable tool is the ability to network with other organizations that are going through the same process so that lessons learned can be shared. 

For more information, please contact Stacie at: