PP371 - AN EVIDENCE-BASED CARE BUNDLE FOR MEDICATION ADMINISTRATION VIA ENTERAL FEEDING TUBE: A QUALITY IMPROVEMENT STUDY

PP371

AN EVIDENCE-BASED CARE BUNDLE FOR MEDICATION ADMINISTRATION VIA ENTERAL FEEDING TUBE: A QUALITY IMPROVEMENT STUDY

S. Memili^1,2,*, R. E. Sezer³, K. Akcay⁴, G. Sain Güven⁵, M. Halil⁶, B. Kelleci Cakir¹

¹Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, ²Department of Clinical Pharmacy, Çukurova University Faculty of Pharmacy, Adana, ³Department of Surgical Nursing, Hacettepe University Faculty of Nursing, ⁴Clinical Nutrition Unit, Hacettepe University Adult Hospital, ⁵Department of Internal Medicine, ⁶Department of Internal Medicine Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Türkiye

Rationale: Medication administration via enteral feeding tubes (EFT), an integral part of enteral nutrition, is a complex process frequently associated with preventable errors. This study aimed to develop, implement an evidence-based care bundle and evaluate its impact on medication safety.

Methods: This quality improvement study was conducted over a 13-month period in internal medicine wards of a tertiary care hospital. Medication administrations via EFT were prospectively observed at two phases (observation and implementation). A four-parameter (medication appropriateness for EFT, preparation, administration, and monitoring) care bundle was developed using the Knowledge-to-Action framework and IHI care bundle methodology and was implemented following structured training. Medication error rates per dose were compared before and after implementation. Severity of errors categorised by using NCC-MERP categories.

Results: A total of 2,064 medication administrations were evaluated. Preparation-administration errors decreased from 3.7±2.3 to 0.9±0.8 per dose (76% reduction, p<0.001) during phases. Monitoring errors were no longer observed after implementation. Key high-risk practices, including inadequate flushing, inappropriate crushing, and dose loss, were largely eliminated. Higher-severity NCC-MERP error categories were eliminated following implementation. Bundle adherence was consistently high (98.3–100%) among nurses.

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Conclusion: Implementation of the care bundle was associated with a substantial reduction in medication errors and improved safety of medication administration via EFT. This approach offers a practical and easily implementable strategy for standardizing care in routine clinical practice.

Disclosure of Interest: None declared