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Nutrition in Clinical Practice
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Tube Feeding Audit Reveals Hidden Costs and Risks of Current Practice

Marcia Silkroski, RD, CNSD

Nutrition Advantage, West Chester, Pennsylvania; Evanston, Illinois; and Chicago, Illinois

Francine Allen, RD, LD

Nutrition Advantage, West Chester, Pennsylvania; Evanston, Illinois; and Chicago, Illinois

Heidi Storm, MS, CNSD

Nutrition Advantage, West Chester, Pennsylvania; Evanston, Illinois; and Chicago, Illinois

A multidisciplinary audit at 11 teaching hospitals assessed hidden costs and quality issues related to tube feeding. Data were collected on 417 tube-fed patients via interviews and review of departmental records. Hospitals averaged 38 tube-fed patients per day and 13 different formulas. Average tube feeding duration was 8.1 days. Hidden costs were identified: 18% to 62% of formulas were wasted per patient per day. The mean annual cost of wasted tube feeding formula per facility was $26,846. Open systems required 14 min/patient/d to manage, compared with 2 min/patient/d for closed systems; the open system required additional administration sets, which cost each facility an average of $47,744 per year; 33% of feedings required additional labor for manipulations. Risks identified included underfeeding of prescribed volume, exceeding hang-time policy, and practices associated with bacterial risk. The audit addressed the need for multidisciplinary evaluation of tube feeding programs to reveal hidden costs and true practices.

Nutrition in Clinical Practice, Vol. 13, No. 6, 283-290 (1998)
DOI: 10.1177/088453369801300604
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