Enteral Formulary Good Shepherd Medical Center - Longview Created by: Clinical Dietitians, 2013

Objectives Participant will be able to identify facility approved enteral products Participant will be able to identify appropriate hang time for an open and closed system Participant will understand signs of intolerance as designated by facility Participants will be able to identify formulary resources available

Enteral Products Jevity 1 Jevity 1.5 Osmolite 1 Standard Formula, fiber; 1kcal/ml, 16.7% protein Jevity 1.5 Standard Formula, fiber; 1.5 kcal/ml, 17% protein Osmolite 1 Standard Formula, no fiber; 1 kcal/ml, 16.7% protein

Enteral Products TwoCal HN Glucerna 1.2 Pulmocare Standard, Concentrated Formula ; 2 kcal/ml, 16.7% protein Glucerna 1.2 Speciality, Carb Steady Formula; 1.2 kcal/ml, 20% protein Pulmocare Speciality, High Fat, Carb Steady Formula; 1.5 kcal/ml, 16.7% protein

Enteral Products Oxepa Vital AF 1.2 Pivot 1.5 Critical Care Formula, Vent Specific; 1.5 kcal/ml, 16.7% protein Vital AF 1.2 Specialized, Semi-Elemental Formula; 1.2 kcal/ml, 25% protein Pivot 1.5 Specialized, Semi-Elemental Formula; 1.5 kcal/ml, 25% protein

Enteral Products Nepro Suplena Specialized, High Protein, Electrolyte Controlled, Impaired Renal Fxn; 1.8kcal/ml, 18% protein Suplena Specialized, Low Protein, Electrolyte Controlled, Impaired Renal Fxn; 1.8kcal/ml, 10% protein

Enteral Products Peptamen Bariatric Critical Care, Semi-Elemental Formula; 1kcal/ml, 37% protein

Modular Products Beneprotein Juven Whey Protein, Given As Flush; 25kcal/scoop, 6g protein Juven Essential Amino Acids, Tissue Building, Increase Lean Body Mass; 86 kcal/pack

Hang Times Closed System (Ready To Hang) Open System (Fill Bag) 48 hours after initial spike and tubing not disconnected from bottle. 24 hours if tubing disconnected from bottle at any time. Open System (Fill Bag) 24 hours only Fill bag to provide 8 hours of feeding, after 8 hours rinse and flush entire system ***Reference Mosby’s Nursing Skills: Enteral Nutrition via Nasoenteric, Gastrostomy, or Jejunostomy Tube

Signs of Intolerance Physical Signs Clinical Signs Complaints of abdominal discomfort, bloating, gas, vomiting Clinical Signs Gastric residual volume > (greater than) 500mL Tubes placed into jejunum (DHT or PEJ) are not appropriate for checking residuals **Refer to Mosby’s Nursing Skills: Enteral Nutrition via Nasoenteric, Gastrostomy, or Jejunostomy Tube for full guidelines.

Resources ALWAYS Consult Dietitian Formulary Card and Conversion Chart Located in nourishment rooms and/or TF storage area on each floor.