• Pauline Cavagna, Simon Bizet, Fabienne Fieux, Emilie Houillez, Caroline Chirk, Chloé Zulian, Jennifer Perreux, Christine Fernandez, Thomas Lescot, and Marie Antignac.
• Pauline Cavagna is a pharmacist, Department of Pharmacy, Saint-Antoine Hospital, AP-HP Sorbonne University, Paris, France.
• Crit Care Nurse. 2022 Dec 1; 42 (6): 546554-65.

BackgroundIn intensive care units, patients are frequently unable to take oral drugs because of orotracheal intubation or sedation.Local ProblemAdverse events occurred during the administration of drugs by feeding tube. This study assessed the impact of implementing good practice guidelines by a clinical pharmacist on the prescription and administration of drugs through feeding tubes.MethodsNonconformity of drug prescription and administration in patients with feeding tubes was assessed before and after implementation of good practice guidelines in the intensive care unit of a large teaching hospital. Data were collected from medical records and interviews with physicians and nurses using a standardized form. Assessment of prescription nonconformity included compatibility of a drug's absorption site with the administration route. Assessment of administration nonconformity included the preparation method.ResultsThe analysis included 288 prescriptions and 80 administrations before implementation and 385 prescriptions and 211 administrations after implementation. Prescriptions in which the drug's absorption site was not compatible with the administration route decreased significantly after implementation (19.8% vs 7.5%, P < .01). Administration nonconformity decreased significantly in regard to crushing tablets and opening capsules (51.2% vs 4.3%, P < .01) and the solvent used (67.1% vs 3.5%, P < .01). Simultaneous mixing of drugs in the same syringe did not decrease significantly (71.2% vs 62.9%, P = .17).ConclusionImplementation of good practice guidelines by a multidisciplinary team in the intensive care unit significantly improved practices for administering crushed, opened, and dissolved oral forms of drugs by feeding tube.©2022 American Association of Critical-Care Nurses.

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