How to Crush Medication for Tube Feeding or Oral Administration

Introduction

• Presenter: Sarah, Registered Nurse at aan.com
• Purpose: To demonstrate how to crush medication for tube feeding or oral administration

Reasons for Crushing Medications

1. Tube Feeding: Medication needs to be a fine powder to be instilled through the tube
2. Swallowing Difficulties: Patients who have trouble swallowing large pills

Supplies Needed

1. Pill crusher
2. Medicine cup
3. 60cc syringe (enteral syringe)
4. Warm water (20cc per pill)
5. Gloves
6. Hand hygiene supplies

Procedure: Crushing Medication for Tube Feeding

1. Follow Hospital Protocols

   • Amount of water before, between, and after medications

2. Preparation

   • Perform hand hygiene and put gloves on
   • Verify right medication and right patient

3. Crushing Medication

   • Place medication in the crusher and twist until fully crushed
   • Empty crushed medication into a medicine cup, ensuring no residue remains

4. Mix and Administer

   • Add 20cc warm water to the medicine cup and mix well
   • Draw mixture into the 60cc syringe
     • Ensure thorough mixing to prevent tube clogging
   • Instill medication into the tube and flush between medications
   • Clean crusher between different medications and different patients

Procedure: Crushing Medication for Oral Administration

1. Preparation

   • Consider using a non-favorite food (e.g., applesauce)
   • Perform hand hygiene and put gloves on

2. Crushing Medication

   • Crush pills individually to avoid interference in effectiveness
   • Mix each pill with a small amount (one spoonful) of applesauce
   • Clean the crusher between pills and different patients

3. Administering Medication

   • Ensure the medication is mixed well to prevent chunks
   • Administer mixture to the patient

Tips for Crushing Medications

1. Not All Medications Can Be Crushed

   • Consult Pharmacy if unsure
   • Over time, nurses will learn which medications can/cannot be crushed

2. Identifying Non-Crushable Medications

   • Medications with letters like LA, CR, XR, SR
   • Five categories to remember: Enteric-coated, Long-acting, Extended-release, Controlled-release, Sustained-release
   • Mnemonic to remember: “Seniors Erroneously Crush Enteric-coated Laxatives”
     • SR: Sustained Release
     • E: Extended Release
     • CR: Controlled Release
     • Enteric-coated: Enteric-coated
     • LA: Long-acting

3. Alternative Forms

   • Consult with physician/pharmacist about liquid or IV forms
   • Consider patient's ability to handle different forms (e.g., liquid consistency needs)

Conclusion

• Summary: Demonstrated procedures and tips for medication crushing
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