Implementation of the Hazard Analysis and Critical Control Point (HACCP) System of an Enteral Feeding System at a Private Local Hospital in Taichung of Taiwan

Enteral feeding system is one of the important therapeutic tools to prevent malnutrition for hospitalized patients. The microbiological index, including total plate count (TPC), coliform, E. coli, Salmonella spp., and Staphylococcus aureus., of an enteral feeding system at a district hospital in central Taiwan was evaluated. The elements of food, food residues in the feeding containers, feeding containers, luer connectors, feeding operators' hands, and working area surfaces were evaluated. A hazard analysis and critical control point system (HACCP) was applied. Various critical control points related to the sanitary conditions were selected and the corresponding corrective actions were taken. The microbial counts of the majority of the samples were significantly reduced. The luer connectors were noted in particular. The microbial counts of TPC, coliform, and E. coli of the luer connectors were 6.95, 5.32 and 4.84 log CFU/mL, respectively. After HACCP implementation, the microbial counts were significantly reduced to 1.52, 0.24 and 0.24 log CFU/mL, respectively. The positive detection percentage of Salmonella spp. and S. aureus of the luer connectors was reduced from 100 and 61% to 0 and 16%, respectively. Similar reduction of microbial count could also be observed in other samples. This study implies that proper monitor and corresponding corrective actions could be used to improve the microbial quality of an enteral feeding system in hospitals.