Safety, quality, and care of nutritional access routes and education of patients/healthcare givers: consensus report from KEPAN.

BACKGROUND/AIM: Nutritional care also encompasses the evidence-based care of enteral and parenteral nutrition access routes and patient/caregiver education, aiming to minimize nutrition-related complications and optimize outcomes. Turkish Enteral Parenteral Nutrition Society (KEPAN) aimed to develop a consensus report to provide concise, clear, and practical recommendations for all healthcare givers to improve the care of nutritional access routes and ensure safety. METHODS: This consensus report was developed by a 12-member working group through a five-phase process conducted over 18 mo (February 2024 to August 2025), involving 6 face-to-face and 18 online meetings. Eighteen questions were identified across 4 sections: 1) Safety of the patient and caregiver and ensuring standard patient care, 2) Care of access routes in enteral nutrition, 3) Care of access routes in parenteral nutrition, and 4) Patient/caregiver education. Recommendations and comments were developed through a systematic literature review, meta-analyses, and randomized controlled trials published after 2010 in the EMBASE, PubMed, and Cochrane databases. Finally, the recommendations were sent to KEPAN extended consensus group, comprising 43 members, using a Delphi methodology. All 18 recommendations were accepted in the first Delphi round, with no items rejected; only minor comments were raised during the first and second rounds. The final report was approved by all 43 panelists without further revision. RESULTS: The consensus report emphasizes standardized protocols and patient safety practices in nutritional care. Key recommendations address safe management of nutritional access routes, including feeding tube positioning and patency, gastrostomy/jejunostomy and catheter/port care, prevention and management of access-related complications, safe medication administration, and structured patient/caregiver education for home nutritional therapy. CONCLUSIONS: This consensus report offers a practical and standardized reference for healthcare professionals involved in clinical nutritional therapy. These recommendations are intended to complement international guidelines and to be applied in consideration of individual patient characteristics, available resources, and local clinical practices.