Administration des médicaments par sonde de nutrition entérale : de l’audit de pratiques à l’élaboration d’outils pour aider le personnel soignant

Abstract

ObjectiveThere are several iatrogenic risks administrating drugs via feeding tubes, so the Anaes made recommendations about it in 2000. This study was organized to investigate on the administration practices and needs of the nurses in order to enlighten their difficulties and to set improvement plans. MethodsDuring 2months, in the ORL service of Saint-Étienne's university hospital, a pharmacist resident evaluated the actual drug administration practices and had private talks with the nurses. ResultsTwenty-six patients on enteral nutrition were included. It appeared that all the drugs were crushed in a small plate and then melt with water before administration. In 21 % of cases, the drug was not suitable with tube feeding. The hand washing was observed in 50 % of the cases and the use of gloves in only 8 %. The 10 individual discussions with nurses show that they suffer from a lack of information (about galenic and risks) and that they need functional tools. Trainings and specific information were displayed as for example a poster of well practicing, a list of galenic forms suitable or not with drug administration and a book with suitable used drugs was distributed. ConclusionDespite of national advices, drug administration via feeding tube remains a source of problems. Thanks to this study, we now know what is done today, and the needs of the care teams; corrective actions can be established.