Some meds may form a precipitate when combined, possibly clogging the tubing. The facility where I work just completed a deficiency free survey. That's right, zero deficiencies! I invited the surveyors to observe me administering a feeding and med-pass via PEG tube.
For set up, I marked each cup with designated med, crushed med individually, and returned it to medpass cup.
I also marked each of two cups with 150 ml, and two with 60 ml indicator lines. I had a cup of lukewarm water ready to combine with each crushed med. Remember to have barriers on the bedside table. I used paper towels. Make sure the syringe, etc is properly dated.
1) Greet resident and ask whether they object to being observed
2) Place appropriate barrier (towel) on lap to catch spills
3) Listen for bowel tones, check placement, check residual, return residual
4) Proceed with feeding; our facility policy states 150 ml tepid water, then formula, followed by another 150 ml tepid water
5) Even though the tubing is clear of formula at this time, policy states to flush with 60ml water, followed by meds, one at a time, with 10ml water between each med. This resident had 7 meds. Then follow with another 60 ml water. Converse with the resident, as you should normally do anyway.
Clean up as per policy.
It seems llike it would take a while, but I do things the way I would do them if a surveyor were present, so it's easy. For this resident, crushing the meds individually probably took an extra minute or two compared to if I had crushed them all together. Hope this helps.