Medication Lost During Administration of Crushed Pills.

Abstract

Background: For patients requiring oral medications but unable to swallow, common nursing practice is to crush the pill, suspend it in water, and administer it via syringe through a gastric tube. Nurses have observed residue left during this process, potentially affecting prescribed dosage.

Objective: To quantify aspirin lost during administration of a crushed pill.

Methods: Nurse researchers partnered with a university chemistry laboratory for this study. A 325-mg aspirin tablet was crushed in a plastic sleeve with a pill crusher, tapped into a medication cup, suspended in water, and injected through a gastric tube into a flask; the tube was then rinsed with additional water. This slurry was dissolved in 100 mL isopropyl alcohol, diluted to 1 L with deionized water, and analyzed with ultraviolet-visible spectroscopy. Light absorbance at 231 nm was compared with a known solution to measure how much aspirin reached the flask. This process was repeated 5 times. Calculations based on data from these experiments quantified aspirin lost during crushing, suspending, and delivering the aspirin to a flask.

Results: For the 5 trials, a mean (SD) of 22.0% (3.1%) of aspirin was lost during the process of crushed pill administration. A mean (SD) of 5.7% (2.7%) was lost in the sleeve and cup, and the remainder was lost between the syringe and the final collection flask.

Conclusions: Quantifying medication loss during the practice of crushing pills for delivery via gastric tube has implications for medication administration.