By Sylvia Foley, AJN senior editor

Research indicates that a “surprising number of nurses”  fail to follow guidelines for preparing and delivering drugs through an enteral feeding tube. (Do you find this surprising? Tell us in the comments!) This can result in medication error and tube obstruction, reduced drug effectiveness, and an increased risk of toxicity.

In this month’s CE feature Drug Administration Through an Enteral Feeding Tube, author Joseph I. Boullata describes the factors to consider before doing so and examines the gap between recommended and common practice. He also explains what the most recent guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend and why.

The ASPEN guidelines include:

• Do not add medication directly to an enteral feeding formula.
• Administer each medication separately though an appropriate access site.
• Liquid dosage forms should be used when available and if appropriate; only immediate-release solid dosage forms may be substituted.
• Dilute the solid or liquid medication as appropriate and administer using a clean oral syringe.
• Avoid mixing medications intended for administration through an EFT.

For the complete guidelines, check out Table 1 in the article. And for more on this and other aspects of  enteral nutrition, visit ASPEN to read the full 2009 Enteral Nutrition Practice Recommendations. (ASPEN guidelines are free, but site registration is required.)