Revised guide for safely administering oral medicines

An updated version of a key guide to safely administering oral medicines to people with enteral feeding tubes or swallowing difficulties has made information easier and faster to scan in a bid to further assist the decision-making of nurses.


Released last month, the comprehensively revised third edition of  The Society of Hospital Pharmacists of Australia’s (SHPA) Don’t Rush to Crush includes 50 additional entries, a clearer format aiming to enhance the focus on patient-centred care and a new small doses section.

An essential resource on hand in hospital wards, aged care facilities and pharmacies across the country, Don’t Rush to Crush 3 was developed in consultation with 650 health professionals and now includes information on 570 oral medicines plus clear monograph features making material easier and quicker to look over.

The guide is a Pharmacy Board of Australia compulsory text for all pharmacies, which stipulates current editions of certain references, in hard copy or electronic format, must be available to pharmacists during dispensing, clinical assessment, reviewing and counselling.

“The new format monographs present a series of options for each medicine, clearly showing whether tablets can be dispersed, dissolved or crushed and the potential subsequent impacts on clinical care,” Editorial Committee Chair and SHPA Board Director Dr Lisa Pont explained.

“Based on feedback and to aid paediatric care, Don’t Rush to Crush 3 also includes a new section ‘What to do for doses less than a whole tablet’ for selected medicines, assisting health professionals when giving very small doses, including instructions for preparing aliquots.”

The Australian Nursing and Midwifery Federation (ANMF) supported the publication’s latest review, which took 18 months, by sending out a survey to its members seeking input on proposed format changes and new advice on part doses.

The call out yielded more than 600 responses, predominantly from nurses.

ANMF Senior Federal Professional Officer Julianne Bryce, a member of the Editorial Committee since the publication was launched in 2011, described Don’t Rush to Crush as an incredibly important resource for prescribers and health professionals administering medicines across a variety of settings.

“The handbook is well used, mostly by nurses and authorised prescribers, in a range of clinical settings including hospitals, community pharmacies, rehabilitation services and residential aged care facilities,” Ms Bryce said.

“Nurses are working in an environment where they need to be able to quickly access information on providing accurate medicines administration for people who have swallowing difficulties or an enteral feeding tube and Don’t Rush to Crush enables this.”

SHPA Chief Executive Kristin Michaels said Don’t Rush to Crush remained a crucial frontline resource to help manage risk and ensure quality care across all healthcare settings, adding she was confident the latest version and new format would enhance the focus on patient-centred care.

Don’t Rush to Crush 3 is available via the SHPA Bookshop

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