Abstract
Ensuring the safe preparation and administration of enteral nutrition is a critical component of clinical care, yet manual processes remain prone to significant errors. This scoping review examined 41 publications—21 research studies and 20 regulatory or best practice guidelines—to evaluate the impact of centralized preparation and bar code scanning technology on patient safety across the lifespan. The review categorized enteral nutrition risks into three primary domains: microbial contamination, preparation inaccuracies, and misadministration. The review identified research reporting manual enteral nutrition error rates as high as 26% to 31%, highlighting the significant risk associated with non-automated workflows.
Research outcomes revealed that transitioning from bedside preparation to a centralized location staffed by dedicated technicians significantly reduces microbial growth. Specifically, facility-prepared formulas were 24 times more likely to show contamination when handled at the bedside. Furthermore, the integration of bar code scanning technology emerged as the most effective barrier against errors, with studies identifying a high volume of "near misses" that may have otherwise gone undetected. Technology also delivered measurable operational benefits, including improved documentation accuracy (rising from 60% to 100% in one study) and substantial time savings for nursing staff, which allowed for more direct patient care.
The review highlights a transformative shift in the regulatory landscape, particularly with the adoption of Regulation (EU) 2024/1938 (the SoHO Regulation). This legislation mandates rigorous standards for the traceability and handling of human milk, requiring European facilities to adopt automated systems, 30-year data retention protocols, and the Single European Code (SEC) by 2027. Despite the clear benefits of these interventions, the review identified a significant geographical gap, as all 21 research studies were conducted in the United States. Future research should prioritize European-based clinical studies, formal cost-benefit analyses across diverse hospital settings, and the impact of these safety frameworks on long-term clinical outcomes such as reduced rates of necrotizing enterocolitis. Ultimately, the transition from manual, reactive processes to proactive digital frameworks is essential for clinical excellence and regulatory compliance in enteral nutrition management.