Drug administration by feeding tube in hospitalized patients. Medication errors waiting to happen

Objetives: In hospitals, medication administration using feeding tubes is common; they are usually used to administer both, nutritional feeding and oral forms of medications. This administration route increases risk of obstruction, requiring frequent replacement and resulting in increased patient morbidity and cost. The aim of the study was to evaluate the medication errors associated with medication administration by feeding tube at the prescription or administration stage of the medication use process. Method: A longitudinal, prospective, observational study of four weeks, in the period between February 27 and March 27, 2017, was designed concerning medication administration in hospitalized patients with enteral feeding tubes. It was carried out in a tertiary hospital (1,350 beds) using an electronic prescription program (Farmatools®). Results: The main objective, the number of medication errors related to the enteral administration route by feeding tubes, was 265 of 1,321 medications administered by tubes. The proportion of medication errors was 20.1% (95% CI: 17.9-22.3). When analyzing medication errors occurred at the prescription stage, we observed that, of the 265 medication errors, 234 (88.3%) concerned a prescription and 31(11.7%) led to an administration error because they could not be intercepted before administering the medication. Conclusions: Medication administration by feeding tubes in hospitals is an important source of medication errors. Most of these failures are generated at the prescription stage leading to later administration errors. In this context, pharmacists play an important role in preventing administration errors in patients dependent on enteral feeding