Clinical Scorecard: Evaluating the Transition from Intravenous to Enteral Medications in the ICU: A Single-Center Study on Reducing the Environmental Impact of Critical Care

At a Glance

Key Highlights

• 63 out of 269 intravenous medications had viable enteral counterparts.
• 86% of eligible medications were classified as Ready for IV-to-enteral substitution.
• Projected reductions of 12.7 tCO₂e and €73,784 in medication costs with 50% substitution.
• Daily medication review is essential for determining treatment appropriateness.
• Enteral absorption can be variable during critical illness.

Guideline-Based Recommendations

Diagnosis

• Assess patient eligibility for conversion to enteral therapy based on clinical appropriateness.

Management

• Implement a multidisciplinary approach for classifying medications for IV-to-enteral substitution.

Monitoring & Follow-up

• Therapeutic drug monitoring may be required for medications classified as Requires monitoring before substitution.

Risks

• Potential for administration errors and adverse drug events with IV therapy.

Patient & Prescribing Data

Patients in the ICU receiving intravenous medications.

Switching to enteral formulations can reduce environmental impact and medication costs.

Clinical Best Practices

• Conduct daily medication reviews to assess the appropriateness of IV therapy.
• Utilize a classification system to guide IV-to-enteral medication transitions.
• Consider patient-specific factors such as organ dysfunction and gastrointestinal function.

Related Resources & Content

• Study on IV medication environmental impact