Hand Hygiene Practices and Microbial Contamination on Feeding Tubes and Other Components of Feeding Systems
Hand Hygiene Practices and Microbial Contamination on Feeding Tubes and Other Components of Feeding Systems
Enteral feeding tube (EFT) and component of feeding systems can serve as a reservoir of
 microorganisms, and the main reason is inappropriate hand hygiene practices. The aim of the
 project is to determine colonization of microorganisms on the EFT and other components and
 assess the relation between colonization and adherence to hand hygiene practices by
 healthcare workers in the intensive care unit.

 This prospective, observational and semi-experimental study will be conducted in one year.
 The project will be completed with healthcare workers and 51 patients who are feeding enteral
 route via nasogastric tube at least for three days. The researchers will provide training to
 healthcare workers in accordance with the World Health Organization (WHO) Hand Hygiene
 Guidelines. Hand hygiene behaviors of the participants will be observed and the question
 forms will be filled before and after training by researchers. The samples for microbial
 analysis will be collected from the EFT by sterile swaps.
Enteral Feeding Tube (EFT) such as Nasogastric Tube (NGT), Duodenal/Jejunal Tube and
 Gastrostomy Tube are frequently used in Intensive Care Unit (ICU). However, EFT is generally
 an omitted/neglected source of contamination. EFT can serve as a reservoir of Methicillin
 Resistant Staphylococcus Aureus (MRSA), which multiplies the risk of mortality by 2-2.5
 times, for microorganism transmission. As a consequence of contamination of EFT,
 microorganisms, that may be manifest with the symptoms such as abdominal pain, distention,
 nausea, vomiting, diarrhea, may reproduce and progress to bacteremia, septicemia and even to
 death. In some studies, it is observed that there is a relation between the contamination on
 the external surface of EFT and contamination on the entry of EFT (hub), and it is also
 reported that the rate of contamination on the hub of the EFT and the environment of the
 patient is quite high. ICU nurses are responsible for sustaining safe and secure feeding,
 medication and fluid replacement of patients. Also, they provide enteral feeding products to
 patients as they are prescribed. Personnel training, proper processing procedures and
 developed enteral feeding protocols are shown to decrease the incidence of bacterial
 contamination on the enteral feeding tube
Inclusion Criteria:

 -  Patients who are 18 years old or older

 -  Being enteral fed via nasogastric tube at least for three days

 -  Patients' relatives approve to be enrolled are going to be included in the study

 -  Nurses and other healthcare providers who work in the ICU

 Exclusion Criteria:

 -  Patients who are being under respiratory, contact or droplet isolation according to
 definitions of Centers for Disease Control and Prevention

 -  Patients' relatives do not approve enrollment