Analysis Of Drug Delivery Through Nasogastric Tube In ICU Patients From 2016 To 2018 In A Primary Hospital

Objective: The clinical pharmacist reviewed the condition of nasal administration in recent 3 years in our hospital,and summarizing the problems existing in nasal feeding.It provides a theoretical basis for clinical pharmacist to guide clinical rational drug use,further guiding the rationality of nasal feeding of ICU.Methods: Retrospective investigation method was adopted.On base of consulting relevant data and designing comment forms,clinical pharmacologist evaluated the rationality of the administration of the nasal feeding of ICU.The application and rationality of medication through feeding tubes for 1052 discharged patient from Jan.1st,2016 to Dec.31 st,2018 were evaluated and analyzed,reviewing,revising and perfecting the evaluation criteria in the process of comment at the same time.The collected data were sorted out with Microsoft Office Excel 2019,the results of comments were summarized,and the data were analyzed by SPSS19.0.Results: ⑴The total number of medical orders were 6685,including 2655 unreasonable medical orders and 4030 reasonable medical orders.After the examination of the rationality of the medical orders,there was no significant difference between 2016 and 2017 in our hospita,the rationality of the medical orders was not changed obviously,and the rationality of the medical orders had been obviously improved in 2018 compared with 2017.⑵According to the results of this comment,the unreasonable drugs use were summarized.The types of problems were divided into 13 types.The main unreasonable types were the choice of dosage form and pharmacological interaction.⑶According to the operation of the nurse,it can be divided into "pre-administration","administration" and "post-administration".Before administration,the selection of dosage forms in 2017 was higher than that in 2016,and in 2018 was lower than that in 2017,the difference was significant.There was no significant difference in whether or not to dissolve drugs in accordance with the way prescribed in the specification,and there was no significant difference in the choice of dosage forms in the middle of three years compared with that in adjacent years.At the time of administration,the rationality of administration time was significantly different after three years of adjacent years.In terms of nasal administration of highly permeable drugs,there was an increase in 2017 compared with 2016,but there was no significant difference in 2018 compared with 2017.After administration,the mixing of EN and drugs increased in 2017 compared with 2016,but there was no significant difference between 2018 and 2017.In the aspect of drug interaction,the trend of drug interaction decreased year by year in the past three years,and the difference was significant.In the aspect of chemical stability,2017 was lower than that in 2016,and2018 was not significantly different from 2017,and there was no significant difference in the administration of drugs with inaccurate segmentation and quantification in some drugs,and there was no significant difference in adjacent years in three years.In terms of adsorption drug application,the rationality of 2017 was significantly higher than that in 2016,and the number of reasonable cases was significantly higher than that in 2017.there was a significant decrease in 2018 compared with 2017,and the difference was statistically significant.In the application of sustained and controlled release preparations and enteric preparations,there was no significant difference in adjacent years in 3 years.The Application of capsules and other dosage forms which were not suitable for nasal feeding were significant differences in adjacent years,showing an upward trend year by year.The undiluted direct nasal feeding of high osmotic solution increased in 2017 compared with 2016,and there was no significant difference between 2018 and 2017.En was not prepared in accordance with the concentration specified in the instruction,which was higher in 2017 than in 2016,and decreased in 2018 compared with 2017.The difference was significant.⑷There were many potential drug-drug interactions.Levothyroxine sodium,calcium,oral hypoglycemic drugs,amiodarone,enteral nutrition preparations and other drugs were listed as pharmaceutical care varieties.Conclusions: ⑴Clinical pharmacists should constantly improve the ability of predicting rational drug use,from retrospection appraisal to pintervention in advance.⑵Pay attention to potential drug-drug interactions and provide early warning for clinicians in time。⑶To improve the professional quality and gradually deepen the concept of rational drug use into ICU in our hospital.