How to Avoid Medication Errors with Tube Feeding

Tube feeding may be needed as a long term way of delivering nutrition at home. Nurses are expected to be knowledgeable about how to give medications through a tube. If you are involved in a case associated with a medication error with tube feeding, here is what you need to know:

The inside of the tube is not that large, about as large as a pencil. It is easy for large fragments to get caught inside the tube and clog it up. It is not easy to unblock the tube. Healthcare providers need to know how to unclog a tube. They need to avoid using colas or cranberry juice to unblock the tube. In the worst case, the tube would have to be removed and reinserted.

If a physician or nurse practitioner orders a new medication, it should be ordered if possible in a liquid form. The liquid form is least likely to cause any blockages.

The nurse should check with the pharmacist to see if the medication can be crushed if it is in pill form. Sometimes the potency of the medication is altered if it is crushed. Pills that cannot be crushed are ones that are enteric-coated, time-release or sustained-released or capsules.

Some medications may not be inserted into a thin feeding tube.

Drug interactions may also affect medications. The interactions may result in the medication becoming useless.

Nurses should flush the tube before and after each medication to remove any residual clumps of pills that could build up to create a blockage and not mix medications together. They may solidify into clumps. The medications should be given one at a time. Nurses should flush the tube every 4 to 6 hours, whenever tube feeding is stopped, and before and after each medication.

Medications should not be added to a bag of tube feeding solution. They may interact with the solution. Also, the goal is for the patient to receive the medication at one time, not over many hours.

There may also be timing issues related to giving the medication when the tube feeding solution is running. Should the solution be stopped for a certain amount of time before the medication is given?

Several factors may lead to medication errors when the patient has a feeding tube. Ask for the facility’s policies on medication administration through feeding tubes.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.