Administering Capsules

[nurs3ros3]

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 with the elderly, or children know, patients cannot always swallow their pills easily and must have the medications crushed in applesauce. However, some of these medications come in a capsule which cannot be crushed. As a new nurse I am following the advice of the other nurses on the floor who have suggested that I crush what I can and then mix whatever I can't in with applesauce. However, I am concerned that this may not be the best option. What other method is there? Can the capsule be opened and the contents emptied into the applesauce or is trying to get the patient to swallow the capsule really the best option?

Any suggestions would be greatly appreciated. I am a new nurse and I want to do the right thing!

Thanks in advance!

[WittySarcasm, BSN]

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.

[wooh, BSN, RN]

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.