Reducing the inappropriate use of parenteral nutrition in an acute care teaching hospital.
BACKGROUND
Parenteral nutrition (PN) is a form of nutrition that can be life-saving, but its use has inherent risks and it is expensive. Nutrition support teams have been shown to reduce both the rate of complications and excessive use of PN.


METHODS
Criteria were established to evaluate the appropriateness of PN use in a 487-bed community teaching hospital. A prospective study of 50 consecutive patients, who received either central or peripheral PN, was conducted.


RESULTS
The 50 patients received 469 days of PN. We found that 233 (49.7%) of the 469 days of PN were avoidable. This resulted in the creation of a formal approval process that required prior approval by a physician-directed multidisciplinary advisory committee before PN could be instituted. The amount of PN subsequently decreased from 500 patient days of PN per month to less than 100.


CONCLUSIONS
This study supports the idea that inappropriate use of PN can be reduced by physician education plus the continuing oversight of a physician-directed multidisciplinary advisory group.
Maurer
J
J
New York Hospital, Medical Center of Queens, Flushing 11355, USA.
Weinbaum
F
F
Turner
J
J
Brady
T
T
Pistone
B
B
D'Addario
V
V
Lun
W
W
Ghazali
B
B
D000368:Aged; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009519:New York City; D010288:Parenteral Nutrition / Q000191:economics / Q000706:statistics & numerical data*; D011446:Prospective Studies