MEDIA INFORMATION from
BAPEN the British Association for Parenteral and Enteral Nutrition
Registered Charity No.1023927
Issued Wednesday, 30 April 2003
NEW INFORMATION RESOURCE ON ADMINISTRATION OF DRUGS VIA ENTERAL FEEDING TUBES AIMS TO REDUCE RISK TO PATIENTS
The British Association for Parenteral and Enteral Nutrition (BAPEN) today presented at Middlesex Hospital, London, an information guide and leaflets on the administration of drugs via enteral feeding tubes for use by clinicians, general practitioners, community pharmacists, patients and carers. Enteral feeding tubes are increasingly used to administer drugs both in clinical and community environments yet no approved training programmes or national guidelines exist in the majority of health authorities. A survey of protocols relating to drug administration via enteral feeding tubes carried out under the auspices of the London School of Pharmacy showed that protocols were in place in only 26% of the 247 hospitals participating in the survey and in only 12% of the 115 health authorities surveyed1. Legal, ethical, pharmaceutical and practical issues surrounding the administration of drugs via enteral feeding tubes have implications for health authorities and for all members of the health care team.
David Cousins, Head of Safe Medicine Practice for the National Patient Safety Agency (NPSA), said: "The NPSA welcomes this resource because it brings together information concerning the appropriate use of enteral feeding equipment and techniques in a concise way, and is tailored to the needs of the staff who will be using it. By highlighting the risks associated with administering drugs via feeding tubes and providing healthcare staff with the right information at the right time, it should help to ensure safer care for patients receiving this treatment."
"It is estimated that 20 - 25,000 adults and children in the UK are receiving home tube feeding at any one time and numbers are growing at approximately 20% year on year [see Note To the Editor No. 2]", stated Rebecca White, Lead Pharmacist: Surgery, Gastroenterology and Nutrition, University College London Hospitals NHS Trust. "Increasingly patients are transferred home on enteral tube feeding and are doing so as a result of cancer, stroke and other neuromuscular disorders, swallowing difficulties, Crohn's disease, gut dysfunction and surgical complications. A significant number of these patients are using their enteral feeding tubes to administer essential medicines."
BAPEN has utilised their multi-professional infrastructure to produce basic information resources: a patient information leaflet, a GP/community pharmacist information leaflet and a multi-professional poster. Educational sponsorships from Baxa Ltd, Fresenius-Kabi Ltd, Merck Gastroenterology, Nutricia Clinical Care, Rosemont Pharmaceuticals Ltd and Tyco Healthcare have enabled these materials to be available to healthcare professionals free of charge. Copies are obtainable from the BAPEN office or may be downloaded as PDFs from the BAPEN website www.bapen.org.uk.
Nutrition nurse specialist, Lynne Colagiovanni, welcoming the BAPEN information resource, said: "Potential problems include drug nutrient interactions and tube occlusion. Little information is available to guide nursing practice in this area and nurses need to work alongside pharmacists to reduce the potential risks to patients. The development of practical guidelines which can be used by nurses, patients and carers in a variety of care settings is the key to success2."
Carolyn Wheatley, Chair of Patients on Intravenous and Nasogastric Nutrition Therapy (PINNT), says: "It is vital that medicines administered via feeding tube are given safely and appropriately. The Record Chart produced by BAPEN allows all individuals fed by tube to understand better what's involved and to work together most effectively with their healthcare professionals in the community as well as in hospital. As a patient and as Chair of PINNT I congratulate BAPEN on making this important resource available."
For further information please contact:
Rhonda Smith
Email: rsmith@gciuk.com
tel: 0207 072 4100
or:
Rebecca White
Email: rebecca@bpng.co.uk
tel: 0207 636 1195
Reference
1. Survey of protocols relating to drug administration via enteral feeding tubes. By R. White and R. O'Neill. Pharmacy Department Middlesex Hospital, London W1T 3AA and London School of Pharmacy, Brunswick Square, London WC1N 1AX. Published by The Nutrition Society, Vol. 61, OCA, Spring 2002.
2. In two studies investigating medication administration by nurses through enteral feeding tubes (Seifert et al, 1995: Naysmith & Taylor, 1998), those nurses who received assistance from the pharmacy were significantly more likely to administer liquid forms than those nurses who reported no pharmacy assistance. Nurses who reported pharmacy assistance also reported less tube obstruction due to medications. 41% of nurses stated that no information on the subject was available.
BAPEN Information Resources available free of charge to health professionals:
"ADMINISTERING DRUGS VIA ENTERAL FEEDING TUBES - A PRACTICAL GUIDE" Step-by-step guide in A3 format for use as a wall chart
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"Drug Administration Via Enteral Feeding Tubes - A Guide for General Practitioners and Community Pharmacists"
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Includes sections on general considerations, types of feeding tubes, preferred formulations, legal implications, drug interactions, tube blockage and sources of information. A4 folded leaflet
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"Tube Feeding and Your Medicines - A Guide for Patients and Carers"
Includes sections for patient's personal information, medication details chart for completion, step-by-step guide and types of medicines. A4 folded leaflet
Copies obtainable from:
BAPEN
Secure Hold Business Centre
Studley Road
Redditch
Worcershire
B98 7LG
Tel: 01527 457850
Fax: 01527 458718
Notes to the Editor
1. BAPEN (British Association for Parenteral and Enteral Nutrition) is a registered charity. It is committed to advancing knowledge about and best practice in artificial nutrition support. Its membership is drawn from the fields of surgery, intensive care, gastroenterology, pharmacy, nursing, nutrition and dietetics.
Log on to www.bapen.org.uk
2. BANS (British Artificial Nutrition Survey) is a standing committee of BAPEN and publishes a report annually based on an audit and research into nutritional care in hospitals and the community. Patient figures quoted in this release are provided by BANS.
3. PINNT (Patients on Intravenous and Naso-gastric Nutritional Treatment) is the charity and patient support group and is a member of BAPEN. It provides help via a network and practical advice on, for example, grants and holidays.
Log on to www.pinnt.com