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Enteral Medication/Nutrition Supplies – Adult/Pediatric – Inpatient/Ambulatory [159]

Enteral Medication/Nutrition Supplies – Adult/Pediatric – Inpatient/Ambulatory [159] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Inpatient Delegation Protocols



Delegation Protocol Number: 159

Delegation Protocol Title:
Enteral Medication/Nutrition Supplies - Adult/Pediatric - Inpatient/Ambulatory

Delegation Protocol Applies To:
All UW Health Hospitals and Clinics
All UW Health retail pharmacies

Target Patient Population:
Adult and pediatric patients with enteral tubes and devices receiving medications and/or nutrition
administration through such devices

Delegation Protocol Champion:
Bartho Caponi, MD – Department of Medicine - Hospitalists

Delegation Protocol Reviewers:
Robin Crist, MS, RD, CNSC - Clinical Nutrition
Joshua Vanderloo, PharmD – Department of Pharmacy

Responsible Department:
Department of Nutrition
Department of Pharmacy

Purpose Statement:
To delegate authority from the provider ordering medications/nutrition for patients with an enteral tube
to pharmacists (RPhs), and Registered Dietitian Nutritionists (RDNs) to write a prescription for enteral
syringes and enteral supplies for the purpose of enteral feeding and/or enteral medication
administration through such a device.

Enteral supplies could include but are not limited to:
• Enteral/oral syringes
• Oral straw tip adapters for oral administration
• Transition adapters for legacy tubes

Who May Carry Out This Delegation Protocol:
Pharmacists and Registered Dietitian Nutritionists who are trained in the use of this protocol and who
have documented completion of training and passed competency.
1. Each Pharmacist and Registered Dietitian Nutritionist completes training as part of the
onboarding process.
2. Competency is assessed as part of the orientation/onboarding process.




Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org

Guidelines for Implementation:
1. The protocol is initiated when the patient has an active order for medications and/or nutrition that
require administration through an enteral tube/device. The RDN or RPh may then order medication
administration supplies, such as syringes, syringe adapters, etc. with refills for one year.
1.1. For ENFit devices RPh or RDN will order ENFit compatible syringes and or supplies.
1.2. For Standard (Legacy) devices RPh or RDN will order standard syringes and or supplies as
needed for administration.
2. The RDN, RPh may change the ordered supplies if dictated by insurance or patient preference.
3. Syringe sizes and quantities may be altered from previous ordered syringe size and quantity by the
RDN or RPh to accommodate volume of medications and/or nutrition.

Order Mode: Protocol/Policy, Without Cosign

References:
1. Anderson L. ENFit: a major patient safety breakthrough. Br J Community Nurs.
2016 Jun-Jul;Suppl Nutrition:S7-8. doi: 10.12968/bjcn.2016.21.Sup7.S7.
2. GEDSA. Global Enteral Device Supplier Association. www.gedsa.org. Accessed March 17, 2017.

Collateral Documents/Tools: NA

Approved By:
UW Health Ambulatory Protocol Committee: May 2017
UW Health Clinical Nutrition Committee: May 2017
UWHC Pharmacy & Therapeutics Committee: June 2017
UWHC Medical Board: July 2017
UW Health Chief Medical Officer: July 2017

Effective Date: July 2017

Scheduled for Review: July 2020
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org