Reduce medication errors in tube feeding administration by establishing administration standards and standardizing operation procedures

Abstract

Medication errors are common during tube feeding administration. These errors involve all aspects of safety and drug use. This study aimed to reduce medication errors associated with tube feeding by establishing standards and standardized operation procedures (SOPs) for tube feeding administration in the intensive care unit (ICU) ward of the First Affiliated Hospital of Bengbu Medical College in China. Prescriptions for tube feeding administration from January 2017 to December 2017 were retrospectively collected and analyzed. ICU pharmacists intervened when inappropriate prescribing occurred during ward rounds, as well as during incorrect tube feeding administration by nurses. Medical staff were trained for proper tube feeding administration. Standards for tube feeding administration and SOPs were established and put into effect in the ICU ward. After the established standard protocol and SOPs were used in the ICU ward, medication errors associated with tube feeding decreased from 1666 cases in 2017 to 331 cases in 2018, representing a decrease of 80.1%. The rate of incorrect tube feeding administration was reduced from 39.9% (1666/4176 cases) in 2017 to 5.9% (331/5627 cases) in 2018. Medication errors involving tube feeding administration in 2017 included drug loss caused by use of inappropriate tools and incorrect operations (29.7%), not flushing feeding tubes before or after administration (14.6%), ignorance of interactions between drugs and enteral nutrition solutions (13.8%), improper use of administered drugs (10.8%) or drug dosage forms (13.8%), and ignorance of drug–drug interactions (10.1%). The rate of these medication errors significantly decreased in 2018. Our study shows that establishment and application of standards for tube feeding administration and SOPs can significantly reduce medical errors associated with tube feeding.