Comparative study of two systems of delivering supplemental protein with standardized tube feedings

Burn patients often require protein supplementation for their nutritional support. Although these are often added to a commercial formula, published standards recommend a 4-hr hang time for manipulated open-system formulas in comparison with 24 hr for unopened closed systems. We hypothesized that use of standard closed-system formulas with the addition of protein flushes via the feeding tube twice daily would reduce nursing time and increase satisfaction. A pilot study included a time study comparing the two methods and a nursing satisfaction questionnaire. Management of an open system consistent with national standards took almost twice as much nursing time daily as the closed system with supplemental protein flushes (36.6 +/- 17.1 min vs 18.6 +/- 3.6 min; P =.051). Sixteen of 17 nurses preferred the closed system with protein flush. The results of this study were used to support expansion of the protocol change throughout the hospital.