Drug administration via enteral feeding tubes in residential care facilities for individuals with intellectual disability: an observational study.
Staff in ID homes skip basic safety steps every time they give drugs through feeding tubes.
01Research in Context
What this study did
Austin et al. (2015) watched staff give medicine through feeding tubes in Belgian homes for people with intellectual disability.
They looked at 862 drug preparations and 268 actual administrations.
The team checked each step against the official feeding-tube drug guidelines.
What they found
Staff skipped or changed steps almost every time.
They mixed drugs that should stay separate, skipped water flushes, and gave tubes only quick rinses.
No one followed the full safe-handling checklist.
How this fits with other research
Fullana et al. (2007) saw the same homes eight years earlier. They found one in every four drug doses had an error, with feeding-tube and inhalation routes the riskiest. E et al. zoom in on those tube errors and show the exact steps staff skip.
Scheifes et al. (2016) add that psychotropic drugs cause adverse events in 84 % of adults with ID and lower quality of life. Sloppy tube delivery can raise those risks.
de Kuijper et al. (2013) link higher antipsychotic dose to more movement side-effects. Giving the dose wrong by tube could change how much drug the body absorbs, so safe tube steps matter even more.
Why it matters
If you supervise or train staff in ID homes, treat every feeding-tube med like a high-risk procedure. Build a short checklist: flush before, give one drug at a time, flush between, final flush after. Post it at the bedside and watch until it becomes habit.
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Join Free →Tape a three-step flush chart above every feeding-tube station and role-play it at the next staff huddle.
02At a glance
03Original abstract
BACKGROUND: The administration of oral medication to patients with an enteral feeding tube (EFT) is challenging. Compliance to guidelines concerning medication administration via EFT has been investigated extensively in the hospital setting. However, studies in residential care facilities (RCFs) for individuals with intellectual disability (ID) are very limited. Therefore, the present study aimed to collect direct observational data on drug administration practices to residents with EFT in multiple RCFs. METHOD: This cross-sectional, observational study was conducted in six Belgian RCFs for individuals with ID. Observations of medication preparation and administration through EFT were carried out in two randomly selected units per participating RCF, on 2 days per unit during all daytime drug rounds, using a direct observation method. Afterwards, the recorded observations were compared with international guidelines on drug preparation and administration through EFT. RESULTS: In total, 862 drug preparations and 268 administrations in 48 residents with EFT were witnessed. Mixing together multiple drugs, not diluting liquid formulations with at least an equal amount of water, not shaking suspensions/emulsions before use, and not selecting the most appropriate dosage form were the most common deviations from medication preparation guideline recommendations. For medication administration, not flushing the EFT with at least 15 mL water was the most common deviation. We also observed high variability in working methods regarding medication preparation and administration via EFT, even between staff members of the same unit. CONCLUSION: This study found that current guidelines concerning medication preparation and administration through EFT are often not followed in Belgian RCFs for individuals with ID. Further research aimed at understanding why current guidelines are not followed seems warranted.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12129