Article Text
Abstract
Background and importance Wrong timing or composition of food or drink with drug administration could have a significant impact on a drug’s therapeutic value or safety. To provide better overall quality provided by health care professionals at the hospital this area should also be improved.
Aim and objectives This project formed part of a larger study focused on medication administration safety in hospital wards. Project goals consisted of identifying risk areas of nurse medication administration. Analysis of the reality will serve as a base to develop suggestions leading to preventive and corrective actions with consequences for the quality of nursing care provided.
One of the risk areas of nursing care is timing drug administration with food as well as food and drink composition. The partial goal was to explore this reality and identify suboptimal and potentially hazardous practices.
Material and methods The research was implemented in four selected cooperating hospitals, specifically in three of their wards – surgical, internal, and follow-up wards in the form of a prospective, multicentric, observation–intervention study. In the first part of this study, all nurses administering medications to all patients hospitalised in each of the above-stated wards during the observation period (morning, noon, evening) were observed by a team of unshadowed external investigators (pharmacist and nurse) for three consecutive days. Data were recorded onto a preprepared recording sheet and subsequently typed into a web database.
Results During this study, 58 nurses administrating 5330 solid oral drugs for 313 patients over 36 days were observed. We discovered that the timing of the food was suboptimal and potentially severe in 18.1% and 2.4% of cases, respectively. In order to ingst a drug, tea was used in 63% of cases, still water in 22% of cases and coffee with milk in nearly 5.8% of cases. Potentially significant drink–drug interactions were identified in nearly 1.5% of cases.
Conclusion and relevance We found that little or no attention was paid to appropriate food, drink and drug management on the wards. These primary data will be used for interventions in this study and as the base for further research.
Conflict of interest Corporate sponsored research or other substantive relationships: Work was supported by a grant from Charles University (SVV 260 551).