Effectiveness of a checklist for enteral medication administration: A randomized controlled trial

Abstract

Background: Enteral nutrition protocols are used when oral nutrition is contraindicated. Medications may be administered through enteral feeding tubes when alternative routes of administration are not available. A brief review of the literature shows a lack of knowledge and inconsistent behaviours among nurses regarding enteral medication administration, which may pose a threat to patient safety. Aim: This study was conducted to evaluate the effectiveness of an enteral medication administration checklist in reducing medication administration errors via enteral feeding tubes. Study Design: A randomized, controlled, triple-blind, experimental design was used. The study was conducted between 2022 March and June in five different intensive care units of a research and training hospital in X city, XX country. Sixty-nine volunteer nurseswere divided into two groups: intervention (n = 34) and control (n = 35) by stratified randomization method. The study was conducted in two steps. First, a checklist for enteral medication administration was developed according to the recommendations of the American Society for Parenteral and Enteral Nutrition, the European Society for Clinical Nutrition and Metabolism and the British Association of Parenteral and Enteral Nutrition. Second, the effectiveness of the checklist on the intervention group in reducing implementation errors was examined. Four data collection tools, including a descriptive information form, enteral medication administration evaluation form, knowledge assessment form and observation form, were used in the study. Results: In the pretest phase, the mean error rate of the control group was 37.49 +/- 18.42, while in the intervention group it was 38.23 +/- 15.08; in the post-test phase, the mean total error rate of the control group was 26.88 +/- 17.56, and it was 2.21 +/- 4.05 in the intervention group. Accordingly, it was determined that the post-test total error rate mean of the intervention group was statistically significantly lower than that of the control group (p < 0.05, t = -8.096 [-30.846; -18.502]). Conclusion: The enteral medication administration checklist reduced errors in the administration of medications through enteral feeding tubes. Therefore, the checklist can be used to reduce errors in medication administration. Relevance to Clinical Practice: This study was conducted to reduce errors in enteral drug administration reported in the literature. With the developed checklist, these errors were reduced, and a standard practice approach was provided to intensive care nurses.