Clinical Decision Support System‐Assisted Pharmacy Intervention Reduces Feeding Tube–Related Medication Errors in Hospitalized Patients: A Focus on Medication Suitable for Feeding‐Tube Administration

Abstract

Background Administering medication through an enteral feeding tube (FT) is a frequent cause of errors resulting in increased morbidity and cost. Studies on interventions to prevent these errors in hospitalized patients, however, are limited. Objective The objective was to study the effect of a clinical decision support system (CDSS)–assisted pharmacy intervention on the incidence of FT‐related medication errors (FTRMEs) in hospitalized patients. Methods A pre‐post intervention study was conducted between October 2014 and May 2015 in Catharina Hospital, the Netherlands. Patients who were admitted to the wards of bowel and liver disease, oncology, or neurology; using oral medication; and had an enteral FT were included. Preintervention patients were given care as usual. The intervention consisted of implementing a CDSS‐assisted pharmacy check while also implementing standard operating procedures and educating personnel. An FTRME was defined as the administration of inappropriate medication through an enteral FT. The incidence was expressed as the number of FTRMEs per medication administration. Multivariate Poisson regression was used to calculate the incidence ratio (IR) comparing both phases. Results Eighty‐one patients were included, 38 during preintervention and 43 during the intervention phase. Incidence of FTRMEs in the preintervention phase was 0.15 (95% CI, 0.07–0.23) vs 0.02 (95% CI, 0.00–0.04) in the intervention phase, resulting in an adjusted IR of 0.13 (95% CI, 0.10–0.18). Discussion Incidence of FTRMEs, as well as the IR, is comparable to previous studies. Conclusion The intervention resulted in a substantial reduction in the incidence of FTRMEs.

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Appropriateness of Long-Term Medications Administered in Tube-Fed Geriatric Patients in Home Health Care; Cross Sectional Observational Study

“…Due to the high prevalence of enteral tube drug administration in the elderly population, which accounts for the majority of patients receiving home health care, initiatives are needed to reduce the risk of medication errors. Many studies have shown that a variety of methods, such as a thorough training program for medication administration through an enteral feeding tube with useful protocols for medical practitioners, strengthening the involvement of clinical pharmacists and dietitians in the home health care and hospital settings, and a software application for ordering and giving medicines that may notify staff to the presence of potential risk with ET administration and interaction, can signi cantly reduce the risk of errors in drug administration (13,(22)(23)(24)(25)(26) . On the other hand, for a considerable number of prescriptions, administration instructions for modifying medications to increase their consumption were missing.…”

Significant Published Articles in 2021 for Pharmacy Nutrition Support Practice

“… Wasylewicz et al 26 Clinical decision support system-assisted pharmacy intervention reduces feeding tube-related medication errors in hospitalized patients: A focus on medication suitable for feeding-tube administration .…”