Impact of a quality improvement programme on the preparation and administration of medications via a nasoenteral feeding tube: 2014–2019 intervention study

Author:

Pereira Rosana AparecidaORCID,Bonacim Carlos Alberto Grespan,da Costa Laís Rosa MorenoORCID,Rigobello Mayara Carvalho Godinho,de Souza Fabiana Bolela,Grande Marcia Mazzeo,Gimenes Fernanda Raphael EscobarORCID

Abstract

AimsEvaluate the impact of a quality improvement programme on the reduction of feeding tube obstruction frequencies, analyse the predictive variables of this safety incident, and estimate the economic costs related to the quality improvement programme during the period from 2014 to 2019.MethodsPlan–Do–Study–Act cycles were performed to test the changes in drug preparation and administration processes via a nasoenteral feeding tube and to evaluate the outcome, process and balance measures. Statistical control charts were elaborated, and the bottom-up direct costing methodology was used to estimate the costs of the improvement programme. The impact of the programme on the monitoring measures was evaluated using logistic regression analysis.InterventionsThe following changes were tested in the hospital participating in the study: acquisition of the Easy Crush equipment for tablet crushing, use of appropriate packaging to crush hard tablets, standardise procedures for scheduling administration times and/or substitution of the pharmaceutical form, educational activities for the nursing team and elaboration and availability of infographics for the nursing team, patients and/or family/caregivers.ResultsThere was a significant improvement in the frequency of tube obstructions, from 41.1% in 2014 to 57.9% in 2015–2017 and 9.6% in 2018–2019 (p=0.0010). After the execution of the improvement programme, it was estimated that the cost of dose preparation was reduced from R$1067.50 in 2014 to R$719.80 in 2015–2017 and R$433.10 in 2015–2019.ConclusionBy re-establishing the processes of drug preparation and administration via a nasoenteral feeding tube, through the acquisition of appropriate equipment for crushing hard tablets, together with educational activities for the nursing team, we could observe a reduction in tube obstructions and the cost of processes.

Publisher

BMJ

Subject

Public Health, Environmental and Occupational Health,Health Policy,Leadership and Management

Reference22 articles.

1. GVIMS . Boletim Segurança do Paciente E Qualidade em Serviços de Saúde N° 15: Incidentes Relacionados À Assistência À Saúde 2017. Available: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/boletim-seguranca-do-paciente/boletim-seguranca-do-paciente-e-qualidade-em-servicos-de-saude-no-15.pdf

2. Gimenes FRE , Baracioli F , Medeiros A de , et al . Factors associated with mechanical device-related complications in tube Fed patients: a multicenter prospective cohort study. PLoS One 2020;15:e0241849. doi:10.1371/journal.pone.0241849

3. Obstrução do Cateter de Nutrição Enteral E a Administração de Fármacos Sólidos NA Unidade de Terapia Intensiva Adulto;dos Santos de Souza;Biológicas & Saúde,2018

4. Costa LFRMd . Redução de Não Conformidades no Preparo E NA Administração de Medicamentos Orais via Sonda Nasogástrica/ Nasoentérica: Impacto de um Programa de Melhoria DA Qualidade. Universidade de São Paulo; 2021.

5. A case of tracheal obstruction caused by reflux and aspiration of semi-solid nutrients via the Nasogastric tube;Nakagawa;Int J Surg Case Rep,2019

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