P444: An intervention aimed at improving junior doctors’ prescribing in a large geriatric department

Abstract

Introduction: Many hospitalized patients require enteral feeding and medication administration via nasogastric tube or percutaneous endoscopic gastrostomy; many of them are elderly patients. The right practice for medication administration via enteral tube includes appropriate formulation, adequate tube flushing, and proper nutrition scheduling. Impaired administration may lead to medication ineffectiveness, toxicity or clogged feeding tube [1]. The aim of our study was to evaluate the current practices and knowledge regarding medication administration via enteral feeding tubes. Methods: Pre-intervention assessment evaluated the knowledge and practices of nurses and pharmacists regarding medication administration via enteral feeding tubes using a self-structured questionnaire or oral questioning. After this evaluation, an intervention through a presentation and new guidelines for the improvement of knowledge and practices was performed. Post intervention assessment was later completed. Assessment results were electronically recorded and analyzed (Microsoft Excel 2010). Results: Pre-intervention assessment was completed in 106 nurses and 10 pharmacists. Knowledge and practice among nurses were lacking; 41% did not receive any training, 75% crush all tablets together, 47% do not flush the tubes before administration. In addition, nutrition scheduling is usually not taken into consideration. Pharmacists’ knowledge was also lacking, especially concerning nutrition scheduling and tube flushing. Post intervention assessment demonstrated improved knowledge. Conclusion: Knowledge and practices of nurses and pharmacists regarding medication administration via enteral feeding tubes is lacking without active intervention. Proper education and clear guidelines can improve knowledge and practice.