Carers' experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies.
Carers' experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies.
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DOI：
10.1111/jcpt.12664
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发表时间：
2018-06
影响因子：
2
通讯作者：
Orlu M
中科院分区：
文献类型：
--
作者：
Alsaeed D;Furniss D;Blandford A;Smith F;Orlu M
在家中使用肠内管喂养正变得越来越普遍，患者的年龄和疾病各不相同。吞咽困难和吞咽困难会影响营养摄入和口服药物的管理，对治疗结果产生负面影响。护理者的用药经验和用药优化还没有得到充分的发掘。这项研究的目的是找出照顾者在药品管理方面遇到的问题；他们制定的应对策略；以及改进药品管理流程的建议。一项在线调查在全国推广；42名照顾者完成了调查。采用描述性统计分析，以及对不限成员名额答复的专题分析。将结果与药物优化的4条原则进行比较。93%的受访者使用肠道喂养管进行药物治疗，但只有62%的人收到了医疗专业人员的建议，只有8%的人收到了如何做到这一点的书面信息。答复确定了照顾者经历的5个药品管理问题；4个他们为应对而制定的战略；以及3个主要方面的建议，以通过在家中进行肠道喂养来改善药品管理。这四条优化用药原则以前并未应用于肠内喂养。我们介绍了护理者的新经历，例如处理不合适的配方和缺乏培训和支持，这应该有助于更好的做法(原则1)。护理人员有时会遇到药物选择不佳的情况(原则2)。照顾者的做法并不总是知情的，可能会影响治疗结果和安全性(原则3)。在护理员培训、教育和支助方面还有改进的余地，以更好地支持药品优化(原则4)。使用肠内管喂养的患者的护理人员在给药时会遇到各种问题，例如应对不合适的配方和缺乏培训和支持。照顾者的做法并不总是知情的，可能会影响治疗结果和安全性。在护理员培训、教育和支持方面还有改进的余地，以更好地支持药物优化。
The use of enteral tube feeding at home is becoming more widespread, with patients ranging in age and diseases. Dysphagia and swallowing difficulties can compromise nutritional intake and the administration of oral medications, affecting therapeutic outcomes negatively. Carers’ experiences of medicines administration and medicines optimization have not been explored fully. The objectives of this study were to identify issues carers experience in medicines administration; the strategies they have developed to cope; and suggestions to improve the medicines administration process. An online survey was promoted nationally; 42 carers completed it. Descriptive statistical analysis was applied, as well as thematic analysis of open‐ended responses. Results were compared against the 4 principles of medicines optimization. 93% of respondents administered medications with enteral feeding tubes, but only 62% had received advice from healthcare professionals and only 8% had received written information on how to do so. Responses identified 5 medicines administration issues experienced by carers; 4 strategies they developed to cope; and 3 main areas of suggestions to improve medicines administration via enteral feeding at home. The 4 principles of medicines optimization have not previously been applied to enteral feeding. We present a novel account of carers’ experiences, for example coping with ill‐suited formulations and a lack of training and support, which should inform better practice (Principle 1). Carers sometimes experience suboptimal choice of medicines (Principle 2). Carers’ practices are not always well‐informed and may affect therapeutic outcomes and safety (Principle 3). There is scope for improvement in carer training, education and support to better support medicines optimization (Principle 4). Carers of patients using enteral tube feeding experience a variety of issues when administering medications, such as coping with ill‐suited formulations and a lack of training and support. Carers’ practices are not always well‐informed and may affect therapeutic outcomes and safety. There is scope for improvement in carer training, education and support to better support medicines optimization.