Errors of oral medication administration in a patient with enteral feeding tube

Shahram Emami, Hadi Hamishehkar, Ata Mahmoodpoor, Simin Mashayekhi, Parina Asgharian, Shahram Emami, Hadi Hamishehkar, Ata Mahmoodpoor, Simin Mashayekhi, Parina Asgharian

Abstract

Enteral feeding tube is employed for feeding of critically ill patients who are unable to eat. In the cases of oral medication administration to enterally fed patients, some potential errors could happen. We report a 53-year-old man who was admitted to intensive care unit (ICU) of a teaching hospital due to the post-CPR hypoxemic encephalopathy. The patient was intubated and underwent mechanical ventilation. A nasogastric (NG) tube was used as the enteral route for nutrition and administration of oral medications. Oral medications were crushed then dissolved in tap water and were given to the patient through NG tube. In present article we report several medication errors occurred during enterally drug administration, including errors in dosage form selection, methods of oral medication administration and drug interactions and incompatibility with nutrition formula. These errors could reduce the effects of drugs and lead to unsuccessful treatment of patient and also could increase the risk of potential adverse drug reactions. Potential leading causes of these errors include lack of drug knowledge among physicians, inadequate training of nurses and lack of pharmacists participation in medical settings.

Keywords: Enteral drug administration; intensive care unit; medication error.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Cornish P. “Avoid the crush”: Hazards of medication administration in patients with dysphagia or a feeding tube. CMAJ. 2005;172:871–2.
    1. Beckwith MC, Feddema SS, Barton GR, Graves C. A guide to drug therapy in patient with enteral feeding tube: Dosage form selection and administraion methods. Hosp Pharm. 2004;39:225–37.
    1. Boullata JI. Drug administration through an enteral feeding tube. Am J Nurs. 2009;109:34–42. quiz 3.
    1. Calabrese AD, Erstad BL, Brandl K, Barletta JF, Kane SL, Sherman DS. Medication administration errors in adult patients in the ICU. Intensive Care Med. 2001;27:1592–8.
    1. Belknap DC, Seifert CF, Petermann M. Administration of medications through enteral feeding catheters. Am J Crit Care. 1997;6:382–92.
    1. Wensel TM. Administration of proton pump inhibitors in patients requiring enteral nutrition. P T. 2009;34:143–60.
    1. Bankhead R, Boullata J, Brantley S, Corkins M, Guenter P, Krenitsky J, et al. Enteral nutrition practice recommendations. JPEN J Parenter Enteral Nutr. 2009;33:122–67.
    1. Camire E, Moyen E, Stelfox HT. Medication errors in critical care: Risk factors, prevention and disclosure. CMAJ. 2009;180:936–43.
    1. Jennane N, Madani N, Oulderrkhis R, Abidi K, Khoudri I, Belayachi J, et al. Incidence of medication errors in a Moroccan medical intensive care unit. Int Arch Med. 2011;4:32.
    1. van den Bemt PM, Cusell MB, Overbeeke PW, Trommelen M, van Dooren D, Ophorst WR, et al. Quality improvement of oral medication administration in patients with enteral feeding tubes. Qual Saf Health Care. 2006;15:44–7.
    1. Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999;282:267–70.
    1. Phillips MS. Handbook of drug administration via enteral feeding tubes. Am J Pharm Educ. 2007;71:99.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe