Nasogastric Tube Feeding and Medication Administration: A Survey of Nursing Practices

Schmieding, Norma Jean; Waldman, Ruth C.

doi:10.1097/00001610-199707000-00003

Cited by 17 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For critically ill patients who cannot consume or have an oral diet, finding ways to administer drugs through the enteral feeding tube presents a challenge. Although administration of medication via enteral tube is specifically a nursing responsibility, they had limited baseline knowledge about pharmaceutical form, drug dosage, or interaction 4,5,10,14…”

Section: Discussionmentioning

confidence: 99%

<p>Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case–control study</p>

Alhashemi¹,

Ghorbani²,

Vazin³

2019

AMEP

View full text Add to dashboard Cite

Purpose Administering drugs and food to patients with swallowing disabilities via enteral tubes requires special skills. This task is a nursing duty and vital to ensure that they do this safely. An integrated program training nurses by a clinical pharmacist is likely to result in improved quality of oral drug administration via enteral feeding tubes. This quantitative study was undertaken to determine the efficacy of a clinical pharmacist educational program for improving nurses’ knowledge, attitudes, and practice (KAP) concerning administrating medication via feeding tubes. Methods This case–control study was performed to evaluate KAP of intensive-care nurses with regard to drug delivery through enteral feeding tubes before and after their training program. A questionnaire focusing on nurses’ KAP was prepared by a clinical pharmacist and reviewed by 18 nurses for its reliability. Then, an educational program was designed for the case group. Two months later, nurses’ KAP in the case and control groups were reevaluated. Nurses’ practice regarding drug administration through feeding tube was observed three times. Results This study was carried out with 82 nurses working in six intensive-care units in two major training hospitals in Shiraz, Iran. The overall knowledge of nurses increased significantly after the training program in the case group, with adequate awareness regarding solid dosage–form crushing increasing from 14% to 63.2% ( P ˂0.001), tube flushing and drug dilution from 32.6% to 81.6% ( P ˂0.001), and knowledge about mixing crushed drugs through a feeding tube from 23.3% to 55.3% ( P ˂0.001). On the contrary, there was no change in the control group. After intervention, nurses’ attitudes in the case group had changed significantly, and 50% of them consulted with pharmacists regarding drug administration. Conclusion An in-service education program by clinical pharmacists can lead to substantial improvements in administration of drugs via enteral feeding tubes.

show abstract

Section: Discussionmentioning

confidence: 99%

<p>Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case–control study</p>

Alhashemi¹,

Ghorbani²,

Vazin³

2019

AMEP

View full text Add to dashboard Cite

show abstract

“…A survey of 219 ICU nurses at a university medical center found that 90 (50%) of 180 respondents considered volumes exceeding 100 ml excessive, 24 but wide variation exists regarding the actual volume considered excessive and the amount returned to the stomach. 25 Current recommendations include evaluating the patient's abdomen for tenderness and bowel sounds and assessing gastric residual volumes every 4-12 hours. 5,8,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] Most clinicians recommend temporarily stopping intragastric EN if residual volume exceeds 100-150 ml and resuming it when the volume declines below 50-75 ml.…”

Section: Clinical Interpretationmentioning

confidence: 99%

“…41 Based on general practice, it is reasonable to assess aspirated gastric residual volumes every 4-12 hours and interpret intolerance as a single volume of 150-200 ml or two consecutive volumes exceeding 100-120 ml. 8,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] A tender abdomen or the presence of hypoactive or absent bowel sounds may aid the assessment of intolerance, but lack of bowel sounds should not contraindicate intragastric EN. The residual volume that may be safely reintroduced has not been studied, but volumes of 50-200 ml are considered appropriate.…”

Section: Clinical Recommendationsmentioning

confidence: 99%

Intolerance to Intragastric Enteral Nutrition in Critically Ill Patients: Complications and Management

MacLaren

2000

Pharmacotherapy

View full text Add to dashboard Cite

Compared with parenteral nutrition, early administration of enteral nutrition (EN) to critically ill patients improves clinical outcomes and reduces infection rates. Intragastric EN often is complicated by intolerance, as indicated by elevated volumes of aspirated gastric residuals. Conflicting data are available for the volume of residual that represents intolerance, but most clinicians use 150-200 ml to signify gastrointestinal motility dysfunction. Intolerance is associated with mortality. Data support an association between intragastric EN and aspiration pneumonia, but little information is available regarding the contributory effect of intolerance. Transpyloric migration of the feeding tube may facilitate tolerance but does not reduce the likelihood of aspiration pneumonia. Prokinetic agents (cisapride, erythromycin, metoclopramide) promote gastric emptying. Results of most studies are limited because patients did not receive or tolerated intragastric EN. Metoclopramide is the agent of choice for treating intolerance. Further studies are necessary before prokinetic drugs can be recommended for preventing intragastric EN-associated aspiration pneumonia.

show abstract

“…Case reports and observational studies of enteral medication error, as well as multiple surveys, have documented inappropriate drug preparation and administration practices. Although >90% of survey respondents are confident in the appropriateness and effectiveness of their method for enteral drug preparation and administration, as many as 1–3 inappropriate techniques have been identified per respondent 67–73 …”

Section: Enteral Drug‐use Processmentioning

confidence: 99%

Enteral Medication for the Tube‐Fed Patient: Making This Route Safe and Effective

Boullata

2020

Nut in Clin Prac

View full text Add to dashboard Cite

The administration of medication through an enteral access device requires important forethought. Meeting a patient's therapeutic needs requires achieving expected drug bioavailability without increasing the risk for toxicity, therapeutic failure, or feeding tube occlusion. Superimposing gut dysfunction, critical illness, or enteral nutrition–drug interaction further increases the need for a systematic approach to prescribing, evaluating, and preparing a drug for administration through an enteral access device. This review will explain the fundamental factors involved in drug bioavailability through the gut, address the influencing considerations for the enterally fed patient, and describe best practices for enteral drug preparation and administration.

show abstract

Nasogastric Tube Feeding and Medication Administration: A Survey of Nursing Practices

Cited by 17 publications

References 15 publications

<p>Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case–control study</p>

<p>Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case–control study</p>

Intolerance to Intragastric Enteral Nutrition in Critically Ill Patients: Complications and Management

Enteral Medication for the Tube‐Fed Patient: Making This Route Safe and Effective

Contact Info

Product

Resources

About