Evaluation of food safety in the handling of home enteral nutrition based on a new contamination risk classification: A cross‐sectional study

Background Home enteral nutrition (HEN) offers clinical benefits and is increasingly used, although handling‐related health risks remain unclear. This study assessed food safety in HEN using a new contamination risk classification. Methods First, the inter‐rater reliability of the Food Safety for Handling HEN checklist was analyzed in 25 households by four evaluators. Then, contamination risk classification was proposed in 64 households, relating food safety adequacy to unacceptable microorganisms in samples of enteral formulations. Food safety was also assessed in these households based on adequacy percentage and contamination risk, considering three HEN categories (food based, mixed, and commercial). Results The inter‐rater reliability indicated substantial agreement (≥0.61) in 88% of the evaluations using the 95% confidence interval. In the proposed classification of contamination risk, households were categorized as high risk (food safety adequacy <57.00%) and low risk (food safety adequacy ≥57.00%; p = 0.0011; Spearman R = −0.428) of contamination. The households that handled commercial enteral formulas (72.75%) showed a higher percentage of compliance compared with preparations with foods (58.68%) and mixed ones (57.27%; p = 0.009). However, all evaluated households were classified as low contamination risk. Conclusion Although it is necessary to improve food safety, especially in the handling of enteral formulations containing food, the three categories of manipulated enteral formulations have proven to be safe options for home use. Furthermore, the proposal for classifying the risk of contamination can be considered a useful tool for identifying the level of contamination risk in handling the HEN.