Impact of direct drug delivery via gastric access devices

Kurien, Matthew; Penny, Hugo A; Sanders, David S.

doi:10.1517/17425247.2015.966683

Cited by 22 publications

(17 citation statements)

References 69 publications

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“…The enteral route of drug administration is unique and differs from the oral administration in several ways. The topic of enteral medication administration is receiving more attention in the literature 5 . Organizations that develop and put into practice protocols for enteral medication administration are much more likely to prevent related medication errors than those that lack protocols 6 , 7 .…”

Section: Section 8 Medication Delivery Via Enteral Access Devicesmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

349

531

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Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

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Section: Section 8 Medication Delivery Via Enteral Access Devicesmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

349

531

View full text Add to dashboard Cite

show abstract

“…The consequence of this practice is the increased risk of physical-chemical incompatibilities and potential drug-nutrient interactions (Fisher and Blalock, 2014). This concomitant administration of medications and enteral formulas could derive potential benefits in regards to time and cost; however, uncertainty exists regarding potential drug and nutrient interactions and the influence this may have on both safety and efficacy (Kurien et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Medication incidents related to feeding tube: A cross-sectional study

Gimenes¹,

Pareira²,

Horak³

et al. 2017

Afr. J. Pharm. Pharmacol.

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The aim is to evaluate the medication incidents relating to incorrect oral medication preparation and administration through enteral feeding tubes in hospitalized patients. A cross-sectional design was used to observe 374 doses of medications at three Brazilian hospitals. The patients consisted mostly of females (48.6%), elderly (65.71%), using polyurethane tubes (82.9%), with jejunal access (82.9%), and circulatory system diseases (45.71%). The most common medication incidents identified were: mixing tablets with other drug(s) (43.5%) and not labelling the prepared medication (60.4%). With regards to incorrect medication administration, not flushing the tube between medications (86.5%) and administering medications together (65.6%) were the most common errors. Tube obstruction was identified in 36.5% of doses administered. There was an association between tube obstruction and mixing tablet with other drug(s); tablet incorrectly reconstituted; tube not flushed prior to medication administration; tube not properly flushed between medications; concurrent administration of a medication and enteral formula; and enteral feeding not interrupted prior to medication administration. The results contribute to the development of knowledge in order to improve hospital nursing practice, especially in developing countries. Future studies should be conducted in order to access patients' outcomes related to incorrect oral medication preparation and administration through feeding tubes.

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“…(45) This regimen is associated with an increased risk of drug nutrient interactions and may also increase intragastric pH leading to bacterial overgrowth. (2) Bolus feeding describes the delivery of 200-400 mL of feed. periodically throughout the day.…”

Section: Feeding Via a Gastrostomymentioning

confidence: 99%

To PEG or not to PEG that is the question

Welbank

Kurien

2020

Proc. Nutr. Soc.

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Nutrition support involves the use of oral supplements, enteral tube feeding or parenteral nutrition. These interventions are considered when oral intake alone fails to meet nutritional requirements. Special diets and oral supplements are usually the first approach to managing malnutrition; however, their role becomes limited when oral intake is restricted or if swallowing is unsafe. Enteral tube feeding or parenteral nutrition are alternative means of providing nutrition support for this select group of patients. Percutaneous endoscopic gastrostomy (PEG) feeding was introduced into clinical practice in 1980. It describes a feeding tube placed directly into the stomach under endoscopic guidance. It is an established means of providing enteral nutrition to those who have functionally normal gastrointestinal tracts, but who cannot meet their nutritional requirements due to inadequate oral intake. The intervention is usually reserved when nutritional intake is likely to be inadequate for more than 4–6 weeks. Although the benefits of PEG have been shown for a select group of patients, there currently exists concerns about the increasing frequency of this intervention, and also uncertainty about the long-term benefits for certain patients. The 2004 UK National Confidential Enquiry into Patient Outcome and Death report emphasised this concern, with almost a fifth of PEG being undertaken for futile indications that negatively influenced morbidity and mortality. The present review paper discusses the indications for, controversies surrounding and complications of gastrostomy feeding and provides practical advice on optimising patient selection for this intervention.

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Impact of direct drug delivery via gastric access devices

Cited by 22 publications

References 69 publications

ASPEN Safe Practices for Enteral Nutrition Therapy

ASPEN Safe Practices for Enteral Nutrition Therapy

Medication incidents related to feeding tube: A cross-sectional study

To PEG or not to PEG that is the question

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