The worldwide process to design and produce new, safer, small
bore connectors is nearing its conclusion. Background information
on the need for redesign and the process involved is at www.chpso.org/post/new-connectors-are-coming.
For California hospitals and skilled nursing facilities, state
law set deadlines of July 1, 2016 and January 1, 2017 for the
adoption of new connectors for enteral and epidural applications,
respectively. But there was not an adequate supply in the U.S.
market for safe adoption of the new enteral (ENFit) connectors by
the July 1 deadline, and there was concern that a similar problem
would occur for epidural applications.
Enteral connectors (ENFit)
Within the past few weeks, some hospitals have identified
sufficient supply of enteral connectors and have begun an orderly
process of changing over. We suggest that all hospitals now
review with their suppliers their particular needs for enteral
products and proceed in switching over when they have identified
sufficient and reliable supply to do so.
Switching over connectors takes planning and time to do safely.
website ENFit section has materials produced by
manufacturers, GPOs, patient safety organizations, and others who
assist in the process. In particular, we recommend the “Take
Action” tab on the ENFit page. Assistance may also be available
from your suppliers and the manufacturers of the products you
use. You may also contact CHPSO for further information.
Recognize that some patients will need to use the old conical
connector—particularly tube feeders using home-blenderized diets,
as the inner bore of the ENFit connector is smaller than previous
Neuraxial connectors (NRFit)
In latest discussions with manufacturers, CHPSO has learned that
supply of most NRFit devices should enter the USA market in
January 2017. However, infusion pump cassettes from certain
manufacturers will not be available until February or March, and
for one manufacturer we do not know when the cassettes will be
Since continuous epidural anesthesia generally uses an infusion
pump, the limiting factor for adoption of NRFit in a hospital may
be the cassettes for the particular pump used at that hospital.
Now is the time to start planning for the transition to the new
NRFit connector, so that when supply is available your hospital
will be ready.
Unlike enteral applications that typically used enteral supplies,
current neuraxial applications often use “intravenous” supplies,
so identification of the new supplies needed will have to include
explicit identification of the intravenous supply use driven by