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Abstract
Objective: To monitor errors in current practice and prepare a manual for proper drug administration through the enteral feeding tube.Methods: It is a prospective observational study conducted for a period of 6 mo in eight departments. The current drug administrations were monitored and checked for the errors which include crushed non crushable solid dosage forms, each drug is not prepared separately, incorrect solution used for dilution, drugs mixed with feeding formula, each drug is not administered separately, not flushed before administration of each drug, not flushed after administration of each drug and others (tablets are not crushed with proper device, motors and pestles are not cleaned frequently, spillage during crushing). Using the data, a manual was prepared and submitted to the physicians of each department.Results: The most prominent error was found to be that the drugs were not prepared and administered separately, tube not flushed before drug administration. Uses of noncrushable tablets were high in neurology. Pantoprazole (enteric coated) and prazosin (modified release) tablets were the most commonly used noncrushable drugs.Conclusion: The study observed the need for developing a standard protocol for drug administration through enteral feeding tube by the pharmacist along with the physician, nursing team to improve the quality of enteral therapy.
Highlights
Enteral tube feeding (ETF) refers to the delivery of a nutritionally complete feed directly into the gut via a tube
The errors include crushed non crushable solid dosage forms, each drug is not prepared separately, incorrect solution used for dilution, drugs mixed with feeding formula, each drug is not administered separately, not flushed before administration of each drug, not flushed after administration of each drug and others
Out of 128 solid dosage forms, 55 solid dosage forms can be substituted with liquid dosage forms
Summary
Enteral tube feeding (ETF) refers to the delivery of a nutritionally complete feed (containing protein or amino acids, carbohydrate, fat, water, minerals and vitamins) directly into the gut via a tube. It is the preferred method of nutrition support in patients who have a functioning gastrointestinal tract but who are unable to be fed orally. Giving medications through a feeding tube can be fraught with errors that occur more often than they are recognized and reported These mistakes are often the result of administering drugs that are incompatible with administration via a tube, of not preparing the medications properly, administering a drug using improper administration techniques. These potential adverse outcomes can lead to patient harm or even death [3]
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