title: Developing and implementing all-in-one standard paediatric parenteral nutrition.
abstract: Parenteral nutrition (PN) is a feeding mode suitable for children that do not achieve requirements via the enteral route. For this intervention to be successful, healthcare professionals require: knowledge on nutrient requirements; access to an aseptic compounding facility; and a system that ensures adequate and safe delivery of PN. Previously, it was thought that individualised PN was the "gold standard" for delivering nutrients to children; however, studies have highlighted concerns regarding inadequate delivery of nutrients, prescribing and compounding errors. We, therefore, set out to develop and implement all-in-one (AIO) paediatric PN solutions. Through a systematic approach, four AIO PN solutions were developed: birth-two months of age (Ped 1); two months-10 kg (Ped 2); 11-15 kg (Ped 3); and 16-30 kg (Ped 4). We implemented them with the help of a teaching pack, over a one month time period, and reviewed usage at six months. At that time, five children initially received standard PN without electrolyte changes; but after a few days, electrolytes needed amendments, and three required individualised PN. A change to AIO PN is feasible and safe; however, some may require electrolyte changes, and there will always be those that will require individualised PN.
authors.affiliation: Department Gastroenterology, Great Ormond Street Hospital Foundation Trust, London, WC1N 3JH, UK. Rosan.Meyer@gosh.nhs.uk
authors.forename: Rosan
authors.initials: R
authors.lastname: Meyer
authors.forename: Meike
authors.initials: M
authors.lastname: Timmermann
authors.forename: Sven
authors.initials: S
authors.lastname: Schulzke
authors.forename: Caroline
authors.initials: C
authors.lastname: Kiss
authors.forename: Marc A
authors.initials: MA
authors.lastname: Sidler
authors.forename: Raoul I
authors.initials: RI
authors.lastname: Furlano
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D057947:Parenteral Nutrition Solutions / Q000592:standards*; D010289:Parenteral Nutrition, Total; D010372:Pediatrics
chemical_list: D057947:Parenteral Nutrition Solutions