Nasogastric Tube Medication Administration

6 Simple Steps:
1. Physicians order should state using the NG tube or the route of administration. 2. Verify placement of the NG tube. 3. Ensure medication is in liquid form to pass the tube. 4. Attach syringe without piston to the tube and deliver med slowly. 5. Irrigate the tube with 30cc NS or H2O after instilling medication. Subtract amount of irrigation solution instilled from the total NG drainage for accurate output. 6. After instilling med, clamp tubing 30 minutes to allow sufficient time for med to be absorbed. Be sure to re-attach to suction, if ordered.

NURSE ALERT: Enteric coated, sustained release and oily medications should NOT be given through
an NG tube. Liquid preparations or soluble tablets are the preferred formulation because they are readily absorbed and less likely to cause an occlusion in the tube.

Evidenced Based Practice - 5 Must Know Facts

Before giving medications, the enteral feeding formula should be stopped. If the absorption of a drug is affected by food or antacids, it is also likely to be affected by enteral nutrition. Medications should be given as a bolus and separated from enteral nutrition. Flushing the tube before and after each medication is imperative to prevent incompatibilities and interactions, decreased drug absorption, tube obstruction and potential microbial contamination. Flushes also ensure total drug delivery. Dilute the medications as appropriate and administer via the feeding tube using a clean oral syringe >30ml in size. Flush the tube again with at least 15ml of water, taking into account the patients volume status. After preparing each medication into a liquid form, label each mixture, per 2014 Patient Safety Goal and keep them separate. Use liquid dosage forms when available and if appropriate. When liquid doses are not available, only use immediate release solid dosage forms. Collaboration with the pharmacy may be necessary.

Presentation by: Hannah Ivery, Mary Beth Smart, Janet Stuttle and Rachel Kingston