Preparo e administração de medicamentos por sondas enterais pela enfermagem em pacientes com nutrição enteral: propostas para garantir o manejo correto

• Autor(a) principal: Lisboa, Caroline de Deus
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11166
• topic: Nursing; Safety; Medication; Enteral Nutrition; Enfermagem; Segurança; Medicação; Nutrição Enteral; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

The research object was the standard of preparation and administration of medications through enteral probes by the nursing on patients who receive concomitant infusion of enteral nutrition. The objectives were: identify the medications and its dosage forms administered through enteral probes in the Intensive Therapy, measure the type, frequency and possibility of errors in the handling of medications in accordance with the dosage form and make a set of proposals that can guarantee the correct handling of medications administered through enteral probes. It was about a research with transversal drawing in an observationalnature, prospective, without intervention model. It was developed in a hospital of Rio de Janeiro where they observed nursing technicians preparing and administering medications through enteral probes at the Intensive Therapy Unit. Were observed 720 doses of medications being prepared and administered. The prevalent medication groups were the ones that act in the renal cardiovascular system (40.55%), followed by the ones that act in the nervous system (19.85%). The error categories were trituration and dilution. Was found a 100% rate of improper trituration for coated tablets and hard gelatin capsules. The insufficient dilution occurred in 100% of the syrup doses. Insufficient trituration for single tablets had a 54% rate. The prevalent error was dilution 84%, for liquid medications. The prevalent error was trituration for solid medications. The errors in the administration were improper handling of the enteral probes and absence of pause. The absence of rinsing of the enteral probes before and between was the most common error (95%) and in almost 90% of the doses there was no pause to administer medications. It was observed that in addition medications being administered without adequate trituration, also there was neither the rinsing of the probe before the administration nor the 15 minutes pause, gathering favorable conditions to the obstruction of the probe. The inadequate preparation and administration of medications may lead to losses in bioavailability, decrease of the serum level and risk of intoxication for the patient. Based on the main errors found, a set of strategies were built to reduce errors. For improper trituration, were proposed labels to identify the medications that cannot be triturated and created a table with the main acronyms identifying controlled release medications. Already for insufficient trituration, a list of alternative medications in liquid form was created and conducting training related to the preparation technique. With this study it became evident that the proper understanding of the factors influencing drug therapy by enteral probes is indispensable for the nurse in regard to the safety of a critical patient care on the usage of enteral probes for enteral nutrition.