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Enteral feeding and medicines administration
Enteral feeding tubes provide access to the stomach or jejunum (small intestine).
They are usually used in cases where there is an obstruction or difficulty in swallowing. The main types of enteral feeding tubes are:
- nasogastric (NG) - a tube passed through the nose directly in to the stomach
- percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) - a tube inserted via the abdominal wall directly into the stomach
- nasojejunal (NJ) - a tube passed through the nose directly in to the jejunum
Medicines given via enteral feeding tubes are often not licensed to be given via this route. The prescriber needs to give:
- clear authorisation for medicines to be given this way
- information on how the medicines should be safely prepared and administered
Giving medicines via an enteral feeding tube and giving medicines covertly are not the same.
If medicines given via a tube are also given covertly, this must be stated. You must have a process for documenting these decisions.
Even though the person is being fed via a tube, you should check if they still able to take their medicines orally. This could be in original form or after crushing or dissolving.
Written information should be available to staff on how to prepare and administer each medicine safely, including oral liquid medicines.
The patient's care plan should cover medicines administration via an enteral tube. It must include all the relevant issues.
Medicines should be administered individually and a flush of water given between each medicine. The amount of flush required should be clearly documented. It should take into consideration if the person is fluid restricted or a child.
Staff should have information available to them on:
- how to safely crush medicine
- which vehicle to use (usually sterile water)
- how much of it to mix the crushed tablet in
Do not prepare medicines in advance for administration at a later time.
Do not leave medicines unattended.
Just because a medicine could easily be given via an enteral tube, it is not automatically suitable for administration in this way. For example, it might not be appropriate to give an oral liquid via an enteral tube.
Seek guidance on each medicine from the prescriber and, also, a pharmacist.
Some medicines are not suitable to be given via a feeding tube as they may block or bind to the tube.
Crushing tablets or opening capsules is usually considered as a last resort.
Dispersible tablets sometimes need to be dissolved in a larger amount of water.
Never use hot water to dissolve the medicine or as a flush.
Make sure people have a regular review of their medicine to see if it is still required or if a more suitable or alternative medicine is available. For example, pain relief may be given via a transdermal patch.
Make a clear record of administration (including the route) on the MAR (medication administration record) chart or equivalent.
Staff must be given appropriate training to prepare and administer medicines via enteral feeding tubes before they undertake this task. This should include a regular competency assessment.
- Last updated:
- 27 January 2020