Paediatric nurses' knowledge and practice of mixing medication into foodstuff

Akram, Gazala and Mullen, Alexander (2012) Paediatric nurses' knowledge and practice of mixing medication into foodstuff. International Journal of Pharmacy Practice, 20 (3). 191–198. ISSN 0961-7671 (

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To investigate paediatric nurses' knowledge and understanding of potential drug stability issues caused by mixing medication into foodstuff. Fourteen paediatric mental health and 16 paediatric general nurses (response rate, 71%) were investigated. With the exception of one nurse, all others reported they had modified oral dosage forms, or had mixed medication with food, prior to administration. The most common foodstuffs were fruit yoghurts, diluting juice and (concentrated) fruit juices. More than half of both cohorts felt sufficiently trained in carrying out the procedure, but 27% did not feel sufficiently knowledgeable about drug stability issues. The in-depth interviews highlighted a knowledge deficit as to the nature of clinical problems that could result from performing the procedures and the associated professional liabilities. Some interviewees expressed reservations about the effectiveness of the dose when administered in this way. Co-mixing was perceived as a time-consuming process and preference was expressed for mixing the powdered dosage form into juice or a liquid rather than into solid foods. Several training issues were identified from this study, including more information about drug/food compatibilities and the need for standardised documentation around the procedures which could be implemented at the ward level. Co-mixing of medication into foodstuff is a common practice. The majority of nurses are unaware of potential drug stability/degradation issues and/or the clinical impact of these practices.