Med crushing - page 3
Hi! If your LTC is anything like where I work, there are alot of meds that get crushed. My question is- do you put them in applesauce or what? I use that or pudding, occasionally ice cream, but one... Read More
Dec 22, '02Occupation: Ob/Gyn RN Joined: Sep '01; Posts: 927; Likes: 2When my daughter was younger I put her theophylline sprinkles in applesauce.To this day she hates applesauce,will not touch it anymore and she is 20.
Dec 22, '02Occupation: RN, ICU/CCU Joined: Aug '02; Posts: 1,062; Likes: 7Originally posted by donmurray
I still have concerns around this subject. In the UK, all meds are individually licenced for use, and that includes the form of presentation. If you crush a tablet, or open a capsule before administering it, you are then technically administering an unlicenced medication.
On the practical side, many meds are timed-release, or packaged to survive passage through the stomach before they begin to act. This function may be impaired, if not negated, by crushing. Crush a sustained-release tab, and the patient gets the whole dose at once! Crush an enteric-coated tab, and the constituents may be destroyed by gastric acids so that the patient gets no dose at all. Crushing meds with a hormonal content, such as Tamoxifen, exposes the staff member to the active ingredients of the drug. If a patient truly has a swallowing problem, then there are a variety of presentations available as alternatives to the tablet form. Most meds are available as liquids, for example.
The other aspect, which I touched on before, is that of consent. Fine if the patient is A&O, and aware that they are receiving their meds in whatever foodstuff is used, but if they are not, then you may be denying them their rights. Starting from the premise that everyone has the right to accept or refuse a treatment, covertly giving a medicine may be a method used to bypass that right for the sake of the nurses' convenience in getting the job done on time.
The nurse who administers the medications needs to help the patient get their meds. Crushing is just one way to do that, and of course is only used on medications which can be safely administered that way.
Forcing a medication is a violation of patients rights, but if the patient is unable to give consent themselves, then consents are obtained from family (or whoever is custodian). So this isn't about bypassing the patient's rights at all -- it is about safely and effectively administering medications to those who need it.
Dec 29, '02Joined: Dec '02; Posts: 8We use applesauce and sometimes pudding for the residents that don't like applesauce. I've tried almost anything that's in complience with meds and diet. As you know some of the Residents in a LTC can be very fussy!!!!!
Jan 9, '03Occupation: NAC, student, mom & wife Joined: Jun '02; Posts: 11I'm a CNA in a LTCF (and student nurse) and my favorite RN puts his meds in vanilla pudding mixed with orange marmalade. The "chunks" from the marmalade help disguise the chunks of meds. I've seen some normally taste-sensitive pts take his mix with barely a grimace.
Jan 9, '03Joined: Oct '02; Posts: 1,671; Likes: 3this thread demonstrates the vital importance of individualizing nursing.