Hi-R-Ed Online

Procedures for Safe Medication Administration from ASPEN

In many cases, medications may be administered through the tube. This poster details information for clinicians and caregivers on asking pharmacists about medications in general (drug-nutrient and drug-drug interactions) as well as instructions on properly using the right form of the medication and if the tube is well-suited for the particular medications prescribed. Reminders and reinforcement on the use of water to dilute medications and flush tubes, methods to appropriately administer medications one at a time, use of the correct medications and syringes, and following established protocols set forth by the care-providing facility and evidence-based guidelines.[6] The poster is available online for free downloading.

Assessment of Enteral Nutrition Tolerance

Let’s move on to some specific items to improve the safety and effectiveness of enteral feedings. Regardless of the setting, patients should be monitored for tolerance and complications. Gastric residual volumes (or GRV) may be checked every 4 to 12 hours, depending on previous measures. That means that if the measure was high (more than 200 ml), GRV should be tested more often to assure that the volume infused is appropriate. Once the measure is lower (less than 200 ml), then the time between measures can be increased.

The other items on this slide are also important to determine enteral nutrition tolerance and will be covered in subsequent slides.

•Gastric residual volume (GRV)

•Gastric reflux

•Distension or cramping

•Diarrhea

•Metabolic changes

6. ASPEN. AWARE poster. Available at: http://www.nutritioncare.org/Professional_Resources/Patient_Safety/Patient_Safety/