Observational studyBMJ open quality2020
Quality improvement programme reduces errors in oral medication preparation and administration through feeding tubes.
Observational study in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Effectiveness of a checklist for enteral medication administration: A randomized controlled trial.Nursing in critical care · 2025Trial
- Cyclical medication management interventions in health care settings: A systematic review.Learning health systems · 2025Article
- Applying a Group Decision-Making Model within a Quality Program to Improve Medication Safety.Florence Nightingale journal of nursing · 2025Article
- Multi-dimensional factors and intervention strategies for nasoenteric tube dysfunction: research progress and future perspectives.Frontiers in medicine · 2025Review
- Medication Administration Through Feeding Tubes in a Tertiary Hospital: A Retrospective Observational Study.Risk management and healthcare policy · 2025Article
- Medication delivery errors in outpatients with percutaneous endoscopic gastrostomy: effect on tube feeding replacement.Scientific reports · 2023Article
- Development of an Administration Guideline of Oral Medicines to Patients with Dysphagia.Medicina (Kaunas, Lithuania) · 2023Article
- Impact of a quality improvement programme on the preparation and administration of medications via a nasoenteral feeding tube: 2014-2019 intervention study.BMJ open quality · 2023Article
- Factors associated with mechanical device-related complications in tube fed patients: A multicenter prospective cohort study.PloS one · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with nasogastric/nasoenteric tube (NGT/NET) are at increased risk of adverse outcomes due to errors occurring during oral medication preparation and administration.
aimTo implement a quality improvement programme to reduce the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients.
methodsAn observational study was carried out, comparing outcome measures before and after implementation of the integrated quality programme to improve oral medication preparation and administration through NGT/NET. A collaborative approach based on Plan-Do-Study-Act (PDSA) cycle was used and feedback was given during multidisciplinary meetings.
interventionsGood practice guidance for oral medication preparation and administration through NGT/NET was developed and implemented at the hospital sites; nurses were given formal training to use the good practice guidance; a printed list of oral medications that should never be crushed was provided to all members of the multidisciplinary team, and a printed table containing therapeutic alternatives for drugs that should never be crushed was provided to prescribers at the prescribing room.
resultsImprovement was observed in the following measures: crushing enteric-coated tablets and mixing drugs during medication preparation (from 54.9% in phase I to 26.2% in phase II; p 0.0010) and triturating pharmaceutical form of modified action or dragee (from 32.8 in phase I to 19.7 in phase II; p 0.0010). Worsening was observed though in the following measures: crush compressed to a fine and homogeneous powder (from 7.4%% in phase I to 95% phase II; p 0.0010) and feeding tube obstruction (from 41.8% in phase I to 52.5% phase II; p 0.0950).
conclusionOur results highlight how a collaborative quality improvement approach based on PDSA cycles can meet the challenge of reducing the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients. Some changes may lead to unintended consequences though. Thus, continuous monitoring for these consequences will help caregivers to prevent poor patient outcomes.
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