Quality improvement of oral medication administration in patients with enteral feeding tubes

BACKGROUND: The correct administration of oral drugs to patients on enteral tube feeding presents a special challenge. As patients are usually unable to swallow oral drugs and many drugs should not be crushed, ways have to be found to administer them through the feeding tube. Measures to improve the quality of oral drug administration in patients with enteral feeding tubes may consist of introducing guidelines, training nurses, or giving patient-tailored advice by the pharmacy. An integrated program comprising all these measures is likely to result in the greatest improvements.

METHODS: A study was undertaken in two Dutch hospitals to investigate the effect of such an integrated program.

RESULTS: The integrated program in hospital I resulted in a decrease in the number of tube obstructions (odds ratio (OR) 0.22, 95% confidence interval (CI) 0.047 to 1.05). There was a significant decrease in the number of administration errors per nurse in hospital II (OR 0.003, 95% CI 0.0005 to 0.02).

CONCLUSIONS: This multidisciplinary program comprising several interventions to promote the correct administration of drugs through an enteral feeding tube results in substantial improvements. As errors concerning administration of drugs to patients with enteral feeding tubes may lead to adverse drug events and loss of effect, these improvements are likely to contribute to a decrease in patient morbidity.