scholarly journals Preparing and administering medications via enteral feeding tubes: a guideline for clinical pharmacists and multi-professional team

2021 ◽  
Vol 12 (2) ◽  
pp. 600
Author(s):  
Danyara BATISTA ◽  
Paula M. OLIVEIRA-LEMOS
Keyword(s):  
Enteral Feeding ◽  
Public Hospital ◽  
Feeding Tube ◽  
Cross Sectional Study ◽  
Second Step ◽  
Cross Sectional ◽  
Feeding Tubes ◽  
Enteral Feeding Tube ◽  
Oral Medications ◽  
Pharmaceutical Form

Objective: To identify the most prescribed drugs by enteral feeding tube in a public hospital and to a guideline for safe medication preparation and administration via enteral feeding tubes. Methods: A cross-sectional study with analysis of the daily prescriptions of patients exclusively using an enteral catheter in intensive care units and inpatients of the medical clinic specialty, in which descriptive statistics were used to identify the prevalence of medication use by tube. In a second step, a protocol was developed for the situation in which oral medications are prescribed to patients with a tube in the digestive tract. Results: A total of 1.810 medications prescribed by enteral feeding tube, of these 1.810, 291 (16%) were prescribed in liquid pharmaceutical form (suspension, solution, syrup) e 1.519 (84%) were prescribed in solid pharmaceutical form (tablets, capsule). 52 medications were selected for the protocol, and 14 of them (26.9%) with the recommendation of not crushing and administering via enteral feeding tube. Conclusion: Our results highlights the performance of clinical pharmacist in monitoring patients with enteral feeding tubes and guidance of multi-professional team. The protocol elaboration will guide for preparation and administration medication through the enteral feeding tube, reducing possible adverse events and ensuring the safety and efficacy of drug therapy.  

scholarly journals Evaluation of prescription containing medication via enteral feeding tubes in an adult emergency unit

2020 ◽  
Vol 11 (4) ◽  
pp. 497
Author(s):  
Inaê A. SPEZIA ◽  
Filipe C. MATHEUS
Keyword(s):  
Health Care ◽  
Enteral Feeding ◽  
Feeding Tube ◽  
Medication Administration ◽  
Health Care Team ◽  
Cross Sectional Study ◽  
Care Team ◽  
Emergency Unit ◽  
Cross Sectional ◽  
Pharmaceutical Form

Objective: This study aims to evaluate medication prescriptions to be used by a feeding tube in an emergency unit, identify and classify the problems with the prescriptions and suggest interventions, done by a pharmacist, when necessary. Also aims to develop a guide with information about administering medication through the feeding tube in order to help the health care team. Methods: the study is characterized as a quantitative cross-sectional study, with data collected during March to September of 2019 at an adult emergency unit, a total of 47 prescriptions were analyzed by a pharmacist and 138 drugs were prescripted to be administered through a feeding tube. Results: A total of 18.8% of those medications presented some restriction to be administered by the feeding tube. The most common problems observed were the loss or reduction of therapeutic effect present in 61,6% of the cases, followed by drug-food interactions with 30.8%. About the pharmaceutical intervention more performed was requesting to change the pharmaceutical form (36%), followed by orientation about stop the enteral feeding (30.2%). To the elaboration of the guide for the health care team, 181 medications standardized at the hospital were analyzed, of that 33.1% presented some restriction to administer by feeding tube and only 35% presented another pharmaceutical form for substitution. Conclusion: it was possible to note the importance of pharmaceutical evaluation of prescriptions to identify errors and prevent future problems assuring the patient’s safety. The guide elaboration sought to assist and optimize the process of medication administration by feeding tube guaranteeing the safety and effectiveness of pharmacotherapy.

Extemporaneous Compounding: A Possible Trigger Tool to Detect potentially health incidents

2021 ◽  
Vol 16 ◽  
Author(s):  
Marina Massae Toma ◽  
Gabriel de Freitas Santana ◽  
Tales Rubens de Nadai ◽  
Fabiana Rossi Varallo ◽  
Jhohann Richard de Lima Benzi ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Scientific Literature ◽  
Feeding Tube ◽  
Cross Sectional Study ◽  
Inclusion Criteria ◽  
Hospital Data ◽  
Cross Sectional ◽  
Specific Patient ◽  
Trigger Tool ◽  
Enteral Feeding Tube

Background: Extemporaneous compounding (EC) involves preparation of a therapeutic product to a specific-patient need. However, there is a potential relation between this procedure and the occurrence of health incidents (HI). The use of triggers tool increases HI identification. Objective: This study assessed the performance of EC as trigger to detect potentially health incidents arising from this procedure. Method: A one-month observational and cross-sectional study was performed in internal medicine ward and intensive care unit of medium-sized hospital. Data collection was carried out in 5 stages: all triggered patients with dysphagia or enteral feeding tube with prescription of EC were included; it was observed all EC executed in standardized drugs prescribed; the procedure was compared with the hospital guide and scientific literature; HI monitoring and their evaluation using WHO and NCC MERP algorithms; a search for pharmaceutical alternatives (PA) that would avoid the observed EC. Results: 197 patients were recruited. Almost half of them were triggered by EC from 84 standardized drugs. 48 patients met inclusion criteria. It was identified 28 adverse drug reactions, 01 therapeutic ineffectiveness and 29 medication errors. EC as trigger tool showed a PPV value of 0.38. Finally, only 24 drugs have PA available in the market, that could avoid one third of all observed EC. Conclusion: It was possible to detect potentially HI in one of two patients with enteral feeding tube using EC as trigger tool. The use of EC as a trigger tool contributes to identify potentially HI arising from drugs, which have not gotten pharmaceutical alternatives to be administered via enteral feeding tube.

scholarly journals Feeding tube placement: auscultatory method and x-ray agreement

2015 ◽  
Vol 36 (4) ◽  
pp. 98-103 ◽  
Author(s):  
Mariur Gomes Beghetto ◽  
Franciele Anziliero ◽  
Dória Migotto Leães ◽  
Elza Daniel de Mello
Keyword(s):  
Enteral Feeding ◽  
Feeding Tube ◽  
Cross Sectional Study ◽  
Tube Placement ◽  
X Rays ◽  
Cross Sectional ◽  
X Ray ◽  
Clinical Nurses ◽  
Enteral Feeding Tube ◽  
The Right

Objective: to evaluate the correlation between the auscultation test and X-ray when detecting the position of an enteral feeding tube. Methods: cross-sectional study in an intensive care unit in southern Brazil, in 2011. Clinical nurse and nurse researcher performed auscultation test recording the impressions regarding the placement of an enteral feeding tube in 80 patients. A doctor evaluated the X-ray. Kappa coefficient and PABAK reviewed the agreements. Results: The X-ray showed that 70% of the enteral tubes were in the stomach, 27.4% in the duodenum, 1.3% in the esophagus, and 1.3% in the right lung. There was a weak correlation between clinical nurses and nurse researchers (PABAK = 0.054; P = 0.103), clinical nurses and X-rays (PABAK = 0.188; P = 0.111) and nurse researchers and X-rays (PABAK = 0.128; P = 0.107) . The auscultation test did not detect two risk conditions, enteral feeding tube in the esophagus and the bronchus. Conclusion: the auscultation test showed little agreement with the X-ray on the enteral feeding tube location.

scholarly journals Esophagojejunostomy Feeding Tube Placement in 5 Dogs with Pancreatitis and Anorexia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Forrest Cummings ◽  
Catherine A. Daley
Keyword(s):  
Veterinary Medicine ◽  
Enteral Feeding ◽  
Feeding Tube ◽  
Tube Placement ◽  
Loose Stool ◽  
Neurologic Diseases ◽  
Feeding Tubes ◽  
Patient Discomfort ◽  
Enteral Feeding Tube ◽  
Feeding Tube Placement

Enteral feeding tube placement has been described in veterinary medicine for several years. Indications include oral, esophageal, gastrointestinal, pancreatic, hepatic, and neurologic diseases. In this paper, endoscopically assisted placement of an esophagojejunostomy (EJ) feeding tube in dogs with pancreatitis and prolonged anorexia is described. To the author’s knowledge there are no published reports of this procedure. Esophagojejunostomy feeding tubes provide an alternative to other forms of postgastric feeding tube placement (e.g., nasojejunal, gastrojejunostomy, and jejunostomy tubes) without the associated complications of patient discomfort, sneezing, epistaxis, and peritonitis. Tube occlusion, transient vomiting and loose stool were the most commonly reported complications.

Efficacy of a Viokace Pancreatic Enzyme Protocol for Clearing Occluded Enteral Feeding Tubes: A Quality Assurance Evaluation

2021 ◽  
pp. 089719002110365
Author(s):  
Heena P. Kurish ◽  
Jacenta M. Gabriel ◽  
Cheryl L. Bruck ◽  
Janice L. Stumpf
Keyword(s):  
Quality Assurance ◽  
Health System ◽  
Enteral Feeding ◽  
Pancreatic Enzyme ◽  
Feeding Tube ◽  
Published Data ◽  
Efficacy Rate ◽  
Feeding Tubes ◽  
Enteral Feeding Tube ◽  
Cohort Quality

Background: A previous retrospective study documented restored patency to 48.2% of occluded enteral feeding tubes using alkalinized Creon pancreatic enzyme capsules. In light of the low efficacy rate, the institutional enteral feeding tube clearance protocol was subsequently revised to incorporate a newly marketed non–enteric-coated Viokace pancreatic enzyme tablet, despite the lack of published data for this indication. Objective: This study aims to evaluate the effectiveness of a Viokace-based alkalinized pancreatic enzyme protocol to clear occluded enteral feeding tubes in a university health system. Methods: This retrospective, cohort quality assurance study included adult and pediatric patients receiving a Viokace-based pancreatic enzyme protocol for enteral feeding tube occlusions in a university health system during a 12-month period. The primary outcome was effectiveness in enteral tube clearance as documented in the electronic medical record. Efficacy of the new protocol was also compared with a Creon-based alkalinized solution using historical data. Results: The Viokace protocol successfully cleared 176 of the 277 (63.5%) occluded enteral feeding tubes occurring in 205 patients included in the analysis. The revised protocol was significantly more effective at clearing occluded enteral feeding tubes ( P = 0.0056) than a protocol using Creon pancreatic enzyme capsules. Conclusion: According to this retrospective evaluation, an alkalinized Viokace pancreatic enzyme protocol was effective in clearing 63.5% of occluded enteral feeding tubes. This significantly higher success rate than previously documented with a Creon-based protocol supports the change in pancreatic enzyme formulations in the institutional protocol.

A Cross-sectional Survey of Enteral Feeding Tube Placement and Gastric Residual Aspiration Practices

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sheeja Perumbil Pathrose ◽  
Kaye Spence ◽  
Christine Taylor ◽  
Kim Psalia ◽  
Virginia Schmied ◽  
...  
Keyword(s):  
Enteral Feeding ◽  
Feeding Tube ◽  
Tube Placement ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Enteral Feeding Tube ◽  
Feeding Tube Placement

scholarly journals Limited Utility of Plain Abdominal Radiographs in Evaluating Intussusceptions Secondary to Long Indwelling Feeding Tubes

2013 ◽  
Vol 3 ◽  
pp. 9
Author(s):  
Albert Yang ◽  
Chandana Lall ◽  
Puneet Bhargava ◽  
David Imagawa
Keyword(s):  
Enteral Feeding ◽  
Pediatric Population ◽  
Feeding Tube ◽  
Adult Intussusception ◽  
Cross Sectional ◽  
Feeding Tubes ◽  
Plain Films ◽  
Cross Sectional Imaging ◽  
Abdominal Radiographs ◽  
Sectional Imaging

Adult intussusception (AI) is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.

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