ABUTH Pharma Journal (2023) · 2023
Olurishe et al.
Background: Medication administration to patients via enteral feeding tubes (EFTs) remains a challenge, is complex and prone to errors. Therefore, addressing the errors and incidents could guarantee the efficacy and safety of medications and improved health outcomes in patients. Objectives: To assess the types and frequency of medication incidents and errors associated with drug administration via EFT among patients in medical wards of tertiary health care facility in northern Nigeria. Methods: A prospective cross-sectional observational study, using a structured data collection form in 49 patients, to assess the incidence and types of medication errors occurring during drug preparation and administration via EFTs among patients in the medical ward. Data collected include demographics of patients, duration of hospital stay and use of EFTs, types and prevalence of medication errors and incidents. The list of drugs administered via EFTs, potential drug-drug, drug nutrient and drug-ETF incompatibilities. Results: A total of forty-nine (49) patients were involved in the study with 1372 enteral drug administrations. A total of 39 different drugs were encountered, with antibacterials (28.09%), antihypertensives (18.49%), and diuretics (13.04%) as the most commonly prescribed class of drugs. Major medication errors identified include: wrong time (26.0%), wrong technique of administration (15.6%) and wrong dose preparation (14.2%). A number of potential drug-drug and drug-EFTs incompatibilities were also observed. There was no significant association P>0.05, between types of medication errors and duration of enteral tube use. The common incidents identified during medication preparation were unlabeled medication (31.5%) and no hand washing (20.1%). While during medication administration, gloves not used (9.1%) and no hand washing (8.6%) were the most identified incidents. Conclusion: Outcome of this study enumerate the various medication errors and incidents associated with drug administration via enteral feeding tube. A practice gap has been identified, as such, involvement of the pharmacists is required for evaluating and reviewing prescriptions for safety, suitability, and compatibility. Training on guidelines and recommendations, development of policies, procedures and a multidisciplinary practice is highly recommended.
Volume: Vol. 1
Issue: No. 1
Pages: pp. 46–55
Year: 2023
Administering medication through enteral feeding tubes (EFTs) is complex and error-prone — crushing enteric-coated or sustained-release drugs, wrong timing, and drug-nutrient interactions can all reduce efficacy or cause harm.
A prospective observational study directly observed medication preparation and administration for 49 patients on EFTs in the medical wards of a tertiary hospital in Zaria, recording error and incident types against ASPEN guidelines.
Across 1,372 enteral drug administrations and 39 distinct drugs, the most common errors were wrong administration time (26.0%), wrong technique (15.6%), and wrong dose preparation (14.2%). The most frequent preparation incidents were unlabeled medication (31.5%) and skipped hand washing (20.1%); during administration, not using gloves (9.1%) and skipped hand washing (8.6%) were most common. Error rates showed no significant association with how long a patient had been tube-fed.
A clear practice gap exists in EFT medication administration. Pharmacist involvement in reviewing prescriptions for safety and compatibility, alongside staff training and clearer protocols, is recommended.