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OHP-061 Parenteral Nutrition: Standarized Process from Prescription to Preparation
  1. L Casorati,
  2. A Ragazzi,
  3. VM Conte,
  4. M Savoldelli,
  5. MG Ottoboni,
  6. D Ferla,
  7. TE Testa
  1. “Ospedale Maggiore” di Crema, Pharmacy, Crema, Italy

Abstract

Background It is widely recognised that Total Parenteral Nutrition (TPN) is essential for the patient’s survival and not just for simple assistance. Therefore, it’s important that sufficient attention is devoted to assessing the patient’s nutritional status. The department of Pharmacy has always been involved in the management of TPN to support the clinical and therapeutic needs of the patient.

Purpose To facilitate the physician’s delicate task of prescribing a balanced nutritional formula, identifying some standard formulas/recipes for parenteral nutrition bags.

Materials and Methods These standard prescriptions have been developed with a nutritionist and the Surgery team and they cover both peripherally administered (low osmolarity) and centrally administered (high osmolarity) solutions. Depending on the patient’s clinical needs, we have standardised prescriptions with different volumes (2000 or 2500 ml). In addition to the patient’s personal data and anthropometric information, these prescriptions already include all the necessary elements for a balanced diet, including calorie requirements, key macronutrients, proteins, water and micronutrients.

Results This review has provided standardised guidance and support to the medical staff in writing the prescriptions for TPN, also giving a range of choices in the initial nutritional approach to the patients. Standardized prescriptions offer a better balance of electrolyte content than those of ready-to use commercial formulations. This approach has improved familiarity with TPN throughout the hospital, by implementing the use of customised bags not only in critical care departments, leading to better cost management.

Conclusions The purpose of nutritional support is not only to avoid malnutrition and its complications, but also to change the pathogenic mechanisms of diseases. For a proper use of artificial nutrition it is necessary to have an in-depth knowledge of the problems of malnutrition. For this reason, it is essential to have a multi-disciplinary approach in which the pharmacist connects different functions.

No conflict of interest.

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