Current practices in the delivery of parenteral nutrition in Australia.
OBJECTIVE
To determine current practice in the delivery of parenteral nutrition (PN) in Australian hospitals.


METHODS
A cross-sectional mail survey.


METHODS
Acute-care adult hospitals with greater than 200 beds in Australia.


METHODS
A total of 67 hospitals (65.7% response rate).


METHODS
Surveys were posted to hospitals. A reminder letter with a second copy of the survey was posted 3 weeks later to non-respondents.


RESULTS
Twenty-seven (40.3%) of the hospitals have a PN team and 50 (74.6%) have a hospital protocol for PN delivery. An inaccessible or non-functional gastrointestinal tract is the most common indicator for commencing PN. Fat infusion is calculated by 24 (38.7%) respondents with a mean (s.d.) maximum amount of fat provided of 2.0 (0.7) g/kg/day. Over half (n=35) reported calculating carbohydrate infusion at a maximum amount of 5.4 (1.0) mg/kg/min. Two-thirds (n=41) reported commencing PN at a rate of 50% or less of goal rate. Blood glucose levels (BGL) were monitored at least once per day by the majority of respondents (n=56, 83.6%). Insulin infusion was commenced at varying BGL. Most respondents (n=40, 59.7%) reported ceasing PN when at least half of the patient's requirements are being met either orally or enterally. A number of practice guidelines were identified and the results of the survey were compared with these guidelines.


CONCLUSIONS
Where there are clear practice guidelines, current practice appears to be in line with these recommendations, however, where evidence is lacking, practice is varied.
Ali
A B
AB
Nutrition and Dietetic Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Azmat_Ali@health.qld.gov.au
Chapman-Kiddell
C
C
Reeves
M M
MM
D000208:Acute Disease; D001315:Australia; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D019538:Health Care Surveys; D006761:Hospitals / Q000592:standards*; D006801:Humans; D009751:Nutritional Requirements; D010288:Parenteral Nutrition / Q000379:methods* / Q000592:standards*; D010348:Patient Care Team / Q000592:standards*; D018579:Patient Selection; D017410:Practice Guidelines as Topic
D004040:Dietary Carbohydrates; D005217:Fat Emulsions, Intravenous