Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case–control study

Abstract

Purpose

Administering drugs and food to patients with swallowing disabilities via enteral tubes requires special skills. This task is a nursing duty and vital to ensure that they do this safely. An integrated program training nurses by a clinical pharmacist is likely to result in improved quality of oral drug administration via enteral feeding tubes. This quantitative study was undertaken to determine the efficacy of a clinical pharmacist educational program for improving nurses’ knowledge, attitudes, and practice (KAP) concerning administrating medication via feeding tubes.

Methods

This case–control study was performed to evaluate KAP of intensive-care nurses with regard to drug delivery through enteral feeding tubes before and after their training program. A questionnaire focusing on nurses’ KAP was prepared by a clinical pharmacist and reviewed by 18 nurses for its reliability. Then, an educational program was designed for the case group. Two months later, nurses’ KAP in the case and control groups were reevaluated. Nurses’ practice regarding drug administration through feeding tube was observed three times.

Results

This study was carried out with 82 nurses working in six intensive-care units in two major training hospitals in Shiraz, Iran. The overall knowledge of nurses increased significantly after the training program in the case group, with adequate awareness regarding solid dosage–form crushing increasing from 14% to 63.2% (P˂0.001), tube flushing and drug dilution from 32.6% to 81.6% (P˂0.001), and knowledge about mixing crushed drugs through a feeding tube from 23.3% to 55.3% (P˂0.001). On the contrary, there was no change in the control group. After intervention, nurses’ attitudes in the case group had changed significantly, and 50% of them consulted with pharmacists regarding drug administration.

Conclusion

An in-service education program by clinical pharmacists can lead to substantial improvements in administration of drugs via enteral feeding tubes.

Keywords:

• clinical pharmacy
• drug administration
• education
• enteral feeding tube
• KAP
• nurses

Acknowledgments

The authors wish to thank Mr H Argasi at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript. This study was a part of Raana Ghorbani's PharmD thesis at Shiraz University of Medical Sciences (thesis grant 93-01-05-8458). The authors thank all nurses who contributed to this study.

Disclosure

The authors report no conflicts of interest in this work.