Application of Hazard Analysis Critical Control Points system to enteral tube feeding in hospital

An HACCP system was implemented for the quality assurance of preparation, s torage and delivery of enteral feeds to patients in hospital. Routine metho ds of feed preparation, storage and delivery to patients were studied and a flow chart was initially made. After identifying hazards, an HACCP team wa s assembled, a flow chart was modified and critical control points were def ined using a decision tree. Control measures for each step of the process a nd its monitoring and corrective measures to be applied were also defined. In addition, feed samples were analysed for microbiological quality and fee d storage temperatures were also recorded, before and after the implementat ion of the HACCP system. When the control measures were applied and monitor ed, the hazard was reduced. Bacterial counts in feed were reduced from 10(5 ) cfu mL(-1) to < 10(1) cfu mL(-1). The results show that contamination of enteral feed may be reduced or eliminated if a systematic approach such as HACCP is applied effectively.