Clinical relevance of parenteral nutrition prescription and administration in 200 hospitalized patients: a quality control study.
OBJECTIVE
Optimal implementation of parenteral nutrition (PN) is required to promote clinical outcome and costs control. This prospective quality control study examined if PN prescription was justified and PN administration was adequate to cover the nutritional needs of patients hospitalized in the Geneva University Hospital.


METHODS
Two-hundred consecutive patients receiving PN were included from Medicine, Intensive Care or Surgery Units. PN prescription was considered justified if oral feeding or enteral nutrition were contraindicated or provided less than 40% of the energy target after 5 days. PN was considered adequate if it covered 90%-110% of the recommended need for energy (i.e., 110% of the Harris-Benedict formula) and proteins (i.e., 1.2 or 1.0 g protein/kg body weight/day for patients < or = or >65 years, respectively), and was supplemented with vitamins and trace elements.


RESULTS
PN prescription was justified in all but 14 patients (7%). However, PN administration was frequently inadequate: overfeeding (62%) was more often observed than underfeeding (14%), particularly among thin, elderly and female patients (P<0.01). Moreover, PN was not supplemented with vitamins and/or trace elements in 47 patients (24%).


CONCLUSIONS
PN prescription is generally justified but PN administration is often inadequate. Further teaching of medical teams and quality control surveys are warranted to optimize PN practices.
Nardo
Patrizia
P
Department of Clinical Nutrition, Geneva University Hospital, Av. Micheli-du-Crest, 28, 1211 Geneva 14, Switzerland.
Dupertuis
Yves M
YM
Jetzer
Josiane
J
Kossovsky
Michel P
MP
Darmon
Patrice
P
Pichard
Claude
C
D004435:Eating; D002149:Energy Intake; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010288:Parenteral Nutrition / Q000191:economics / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D011786:Quality Control