三级医院经鼻饲管给药：一项回顾性观察研究
Medication Administration Through Feeding Tubes in a Tertiary Hospital: A Retrospective Observational Study.
作者信息
Zhu Yuanchao, Zhu Bolin, Jin Pengfei
机构信息
Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application(Beijing Hospital), Beijing, 100730, People's Republic of China.
出版信息
Risk Manag Healthc Policy. 2025 Feb 1;18:319-328. doi: 10.2147/RMHP.S500557. eCollection 2025.
AIM
This study aimed to investigate the prevalence and types of errors associated with oral medication administration via feeding tubes (FTs) in a tertiary hospital in Beijing.
METHODS
A retrospective observational study was conducted at Beijing Hospital between January 2018 and December 2022. All inpatients aged of 18 and above who received at least one oral medication via FTs were included. Medical records were meticulously collected and analyzed.
RESULTS
A total of 7,243 patients were identified as part of the tube feeding group, representing a prevalence rate of 6.26% among hospitalized patients receiving oral medication. Compared to the general hospitalized population, patients in the tube feeding group exhibited a higher proportion of male patients (59.74% vs 48.91%), older age [(68.00±14.99) vs (59.75±16.38)], lower weight [(65.75±13.32) vs (67.82±12.72)], increased rates of being bedridden (18.06% vs 5.38%), longer hospital stay [(21.56±28.12) vs (8.88±10.38)], and a greater number of prescribed medication types [(51.21±19.37) vs (23.35±15.04)]. On average, patients in the tube feeding group were administered 8.92±6.78 types of oral medications. A significant percentage of patients in the tube feeding group experienced inappropriate medication administration, reaching 65.43%. Among these cases, the rate of inappropriate medication administration for patients receiving nasogastric tube and nasojejunal tube were 64.06% (4186/6535) and 78.11% (553/708), respectively. In total, there were 10,164 instances of inappropriate medication administration, averaging 1.40 times per patient in the tube feeding group. Inappropriate medications included enteric-coated drugs, modified-released, soft capsules, and other non-crushable drugs.
CONCLUSION
Our results Our findings highlight a significant issue of inappropriate medication administration via FTs. Ensuring the accurate administration of orally prescribed medications to patients with FTs is a complex task that requires immediate attention.
目的
本研究旨在调查北京一家三级医院经鼻饲管（FTs）口服给药相关错误的发生率及类型。
方法
于2018年1月至2022年12月在北京医院开展一项回顾性观察研究。纳入所有年龄在18岁及以上、至少通过鼻饲管接受过一次口服给药的住院患者。对病历进行了细致收集与分析。
结果
共确定7243例患者为鼻饲组，在接受口服给药的住院患者中患病率为6.26%。与普通住院人群相比，鼻饲组男性患者比例更高（59.74%对48.91%），年龄更大[（68.00±14.99）对（59.75±16.38）]，体重更低[（65.75±13.32）对（67.82±12.72）]，卧床率更高（18.06%对5.38%），住院时间更长[（21.56±28.12）对（8.88±10.38）]，且处方药物种类更多[（51.21±19.37）对（23.35±15.04）]。鼻饲组患者平均接受8.92±6.78种口服药物给药。鼻饲组中有相当比例的患者存在用药不当情况，达到65.43%。其中，接受鼻胃管和鼻空肠管给药患者的用药不当率分别为64.06%（4186/6535）和78.11%（553/708）。鼻饲组总共出现10164例用药不当情况，平均每位患者1.40次。不当药物包括肠溶片、缓释片、软胶囊及其他不可碾碎的药物。
结论
我们的研究结果突出了经鼻饲管给药不当这一重大问题。确保向经鼻饲管给药的患者准确给药是一项复杂任务，需要立即予以关注。
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