Adult parenteral nutrition utilization at a tertiary care hospital.
BACKGROUND
Guidelines from the American Society for Parenteral and Enteral Nutrition promote appropriate use of parenteral nutrition (PN). In addition, involvement of multidisciplinary nutrition support teams (NSTs) has led to a reduction of inappropriate PN administration. This study evaluated the effect of introducing hospital-wide PN guidelines and a PN review committee on PN prescription behavior of NSTs in the authors' hospital.


METHODS
A PN guidelines form with established indications was developed and made available to the NSTs. A PN review committee was formed to assess the appropriateness of PN prescriptions and educate the NSTs if an inappropriate PN prescription was noted. The initial-phase PN prescriptions were compared with those in a later (established) phase.


RESULTS
Of a total of 614 PN prescriptions, 8.1% did not meet the established indications. The initial phase recorded 312 PN prescriptions, and the established phase had 302 prescriptions. The number of inappropriate PN prescriptions decreased significantly from 11.9% in the initial phase to 4.3% in the established phase (P = .001).


CONCLUSIONS
The incidence of inappropriate PN prescription was low when NSTs were closely involved in patient care. Availability of written guidelines and continuous oversight of NSTs promoted appropriate PN usage.
Kohli-Seth
Roopa
R
Mount Sinai School of Medicine, New York, New York, USA. roopa.kohli-seth@mountsinai.org
Sinha
Rakesh
R
Wilson
Sara
S
Bassily-Marcus
Adel
A
Benjamin
Ernest
E
D000328:Adult; D019983:Guideline Adherence; D006761:Hospitals / Q000592:standards*; D006801:Humans; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000706:statistics & numerical data*; D010348:Patient Care Team; D010606:Pharmacy and Therapeutics Committee; D017410:Practice Guidelines as Topic; D055656:Prescriptions / Q000592:standards; D011785:Quality Assurance, Health Care; D012955:Societies, Medical; D019564:Unnecessary Procedures / Q000706:statistics & numerical data