Abbott Customer Communication COVID-19: Ongoing Management of Tube Feeding Patients in the Hospital Setting March 2020

Due to the ongoing increase in the prevalence of COVID-19 infections across the UK, we anticipate a significant increase in the demand for Abbott FreeGo pumps for patients requiring tube feeding in both existing and newly established intensive care units.

Abbott is committed to the care and wellbeing of all patients that are currently receiving our tube feeds. We therefore wish to work closely with you to ensure that your patients continue to receive their feeds without interruption.

Management of Pump Resources

Before requesting pumps for your hospitals can you please:

• Check the existing stock allocated to your hospital and identify pumps that are not currently being used.
• Protect any unused pumps and prioritise them for patients on ICU units, particularly in hospitals where ICU bed numbers are being increased.
• Consider returning hospital pumps to Abbott if stocks are greater than required. This will enable us to redeploy them to areas of the country where the need may be greater.
• Return any unused or faulty pumps to the Abbott service centre to be cleaned, serviced and if necessary prepared for redistribution.
• Be aware that Abbott Nurses have proactively been contacting community patients to check if they have multiple pumps that are no longer required or not in use.
• Be aware that the management of Buffer pumps remains unchanged. There is no need to request additional pumps for discharge in the hospital.
• Be aware that Abbott nurses continue to prioritise patient discharges to help free up hospital beds as per Government COVID-19 Hospital Discharge Service Requirements.
• Where possible consider existing community tube fed patients who are using a pump but could be transitioned to bolus or gravity feeding – and return the pump to Abbott for redistribution.
• Be aware that there is no requirement for community teams to request emergency pumps or feed/ equipment supplies. The Hospital2Home service and out of hours service will continue to manage any emergency requirements in the normal way.
• Please organise for pumps to be uplifted and collected by contacting Abbott.devicetracking@nhs.net / phone 01795593312

Please note any changes to hospital or community patient services will be communicated to you as soon as possible

Options to consider if pumps are limited in the hospital setting

• For less severely ill patients, use pump sharing in 12-hour shifts, i.e. use a pump for more than one patient. Ensure pumps are sanitised between each patient.
• Use larger, less frequent water flushes to reduce administration time/resource required.
• Consider bolus feeding using an enteral feeding syringe or gravity feeding as options for suitable patients.
• If additional fluid is needed it can be administered using an enteral feeding syringe.

Alternative Feeding Methods During Periods of Peak Demand

Bolus Feeding using an enteral feeding syringe

This option allows a set amount of feed to be given as required without the need for a feeding pump. The feed is given over a period of time using an enteral feeding syringe. This option may be appropriate for patients on wards who are considered suitable candidates for bolus feeding using an enteral syringe as an alternative to pump feeding. It may also be suitable for patients being discharged into the community, reducing the need for a pump. Consider:

• patients who are able to tolerate bolus volumes.
• patients or carers that are able to administer bolus feeds.
• patients that are able to maintain a safe feeding position.
• existing patients in the community currently using a pump who could move to bolus feeding.

Gravity Feeding

This option allows a set amount of feed to be given as required without the need for a feeding pump, using a gravity feeding set. This option may be appropriate for patients on wards who are not considered suitable candidates for bolus feeding using an enteral feeding syringe.

Consider:

• patients that can be fed over a longer period.
• patients requiring continuous feeding who are not critically ill.

For your information, we have leaflets available for bolus and gravity feeding for both children and adults. Please contact the Abbott Nutrition freephone nutrition helpline on 0800 252882 or ukabbottnutrition@abbott.com

The Critical Care Specialist Group (CCSG) of the BDA have also released Guidance on the management of nutrition and dietetic services during the COVID-19 pandemic. Please click here for more information

We hope that these alternative methods of tube feeding will help you in the ongoing management of hospitalised patients requiring enteral feeding by reducing pressure on Abbott FreeGo pump availability during the current COVID-19 outbreak.