Evaluation of nurses' knowledge of oral solid dosage forms that should not be crushed at a university hospital in Oman

Objective: To evaluate nurses' knowledge of oral solid dosage forms that should not be crushed at Sultan Qaboos University Hospital (SQUH), Oman, the methods used in crushing and the references consulted prior to crushing. Method: A questionnaire-based study of a convenience sample of nurses in inpatient practice areas of SQUH, Oman, from 14 to 21 of November 2012. Key findings: One hundred twenty-six (76.51%) of nurses regularly crushed oral solids for patients who are unable to swallow. Eighty-seven point thirty per cent (145) are aware that there are some specially formulated oral solids that should not be crushed, but only 38% (63) could correctly indicate how such medications can be recognised. Only half of nurses check the pharmaceutical characteristics of oral solids before crushing. When multiple medications are prescribed for a patient who cannot swallow, 42.16% (70) crush all together and mix with some water before giving to the patient. Five point seven per cent (10) of nurses put on personal protective equipment all the time before crushing, 26.58% (27) rarely and 25.95% (49) never do. Sixty-nine point three per cent (115) consult their pharmacist when they are in doubt about crushing. Conclusions: Crushing of oral solid dosage forms was common among nurses in SQUH. There were knowledge deficits regarding special formulations that should not be crushed. When oral solids were crushed, attention to possible drug-drug, drug-food interactions, contamination and safety was overlooked. Majority of nurses consulted their pharmacist when in doubt about crushing. Further research is required to see if collaboration among nurses and pharmacists would improve this practice.