Administering Capsules - page 3

Nurses: I need your help! I am a brand new nurse and just started a job at a nursing home. I have a question regarding the administration of a capsule medication to those who cannot swallow pills. As those of you who work... Read More

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    Thanks everyone for the input, I am glad I asked the question!!

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  2. 2
    I didn't have time to read the whole thread and I hope someone has already referred you to this but if not here it is

    http://www.ismp.org/Tools/DoNotCrush.pdf

    This link is for the ISMP do not crush list. It is a great resource. I am new to ltc and I shared many of the same concerns you did. This list was really a big help!
    I found one drug I was giving was a chemotherapeutic agent that you should wear gloves when administering and that another drug I was giving you could open the capsule as long as you didn't crush the contents and didn't put it in chocolate pudding.....Who knew? I was so happy to find this and I hope it is a blessing to you too.
    wooh and Forever Sunshine like this.
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    Quote from AuntieDi
    I didn't have time to read the whole thread and I hope someone has already referred you to this but if not here it is

    http://www.ismp.org/Tools/DoNotCrush.pdf

    This link is for the ISMP do not crush list. It is a great resource. I am new to ltc and I shared many of the same concerns you did. This list was really a big help!
    I found one drug I was giving was a chemotherapeutic agent that you should wear gloves when administering and that another drug I was giving you could open the capsule as long as you didn't crush the contents and didn't put it in chocolate pudding.....Who knew? I was so happy to find this and I hope it is a blessing to you too.
    Chocolate pudding has been my lifesaver when giving meds to confused residents.
  4. 0
    Quote from K+MgSO4
    No do not open the capsule. The med is in it for a reason to protect from gastric juices or so that it is SR. You need to talk to the pharmacy and the doctor about getting another version of this tablet. It may require more frequent dosing as IR rather than SR.
    VERY VERY True!! NOT all capsules can or should be opened!!!! There is a reason they are in capsules. AND if you talk to the pharmacy your facility deals with and they find out that the patient needs there meds crushed they are usually very good at supplementing with liquids or another alternate med or something. Then contact the Dr. Most Dr's are not made aware the patient needs there meds crushed and will agree with alternatives pharmacy suggests for such cases. Also, if order calls for PO, then thats what they mean....by mouth and as dispensed. IF for ANY other reason, you have to crush, place in applesauce, pudding, juice, Gtube, etc, YOU NEED AN ORDER!! You need an order from MD to administer medications crushed in pudding/applesauce in order to be doing so! If state was to come into our facility and we were seen crushing meds and placing them in pudding, not having an order, we would be dinked big time!! As PO stands for med to be given as dispensed, whole, capsule,liquid or otherwise.
  5. 0
    I usually use this list- http://www.ismp.org/tools/donotcrush.pdf

    Which is a common list that is in a lot of mars of LTC's. If you have the list in your mars just check and see if it is in the DO NOT list. If it is not and the resident needs pills crushed, then just open it and pour the applesauce.

    Any meds that have ER (Extended Release) or SR (Sustaned Release) you cannot open and those you may need to call the doctor or pharmacy and see if there is another way to give the meds.
  6. 0
    Don't forget that sometimes the need to crush is taken into consideration with non-crushable meds. I've seen quite a few times a small dose ordered crushed and given more frequently because for certain patients, that was the best way to go. Very rare to have hard and fast rules in nursing and medicine.


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