Are nutrition support teams useful? Results from the NCEPOD study into parenteral nutrition

Purpose – The purpose of this paper is to explore parenteral nutrition (PN) practices in hospital pharmacies of Kuwait and identify potential avenues for quality improvement in this service. Design/methodology/approach – A descriptive, qualitative study about PN practices was conducted from June 2012 to February 2013 in Kuwait. Data were collected via in-depth semi-structured interviews with the head total parenteral nutrition (TPN) pharmacists at seven hospitals using a developed questionnaire. The questionnaire obtained information about the PN service at each hospital including the existence of nutritional support teams (NSTs), PN preparation practices, quality controls and guidelines/protocols. The interviews were audio-recorded, transcribed verbatim and analyzed for content. Findings – Seven hospitals in Kuwait provided PN preparation service through TPN units within hospital pharmacies. Functional NSTs did not exist in any of these hospitals. All TPN units used paper-based standard PN order forms for requesting PN. The content of PN order forms and PN formulas labeling information were inconsistent across hospitals. Most of the prepared PN formulas were tailor-made and packed in single compartment bags. Quality controls used included gravimetric analysis and visual inspection of PN formulations, and less consistently reported periodic evaluation of the aseptic techniques. Six TPN units independently developed PN guidelines/protocols. Originality/value – This study revealed variations in many aspects of PN practices among the hospitals in Kuwait and provided recommendations to improve this service. Standardization of PN practices would enhance the quality of care provided to patients receiving PN and facilitate national monitoring. This can be accomplished through the involvement of healthcare professionals with expertise in nutrition support working within proactive NSTs.

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Evaluation the Role of Nutrition Support Team for Monitoring the Types, Complication, Nutrients and Drugs Provision in the Parenteral Nutrition

International Journal of Research and Review ◽

10.52403/ijrr.20211256 ◽

2021 ◽

Vol 8 (12) ◽

pp. 454-462

Author(s):

Aisha Alshikhy ◽

Hanaa Almasallati ◽

Marwa Abu Saif

Keyword(s):

Parenteral Nutrition ◽

Medical Center ◽

Nutritional Therapy ◽

Intervention Programs ◽

Nutrition Support ◽

Support Teams ◽

Support Team ◽

Macro And Micronutrients ◽

Unconscious Patients

Parenteral nutrition (PN) is a form of administering nutrients, include water, macro and micronutrients and is one of widely used mode of therapy used in patients who are unable to tolerate oral or enteral feeding. Therefore, the success of nutritional therapy depends chiefly on nutrition support teams. The aim of the present work to evaluation the provision of parenteral nutrition in the Benghazi medical center. A total of 86 patients were involved in the study and numbers of questions were answered from nutrition support team at the hospital. The result revealed that PPN (IV drip) most common used and mixture of dextrose and sodium chloride were highly provision in the hospital. Furthermore the Doctors at the ward were shown have fully responsibility for provided PN but there were neglected role of dietitian and pharmacist. Patients monitoring were not carried out routinely. Most drug delivered by PN found NSAIDs and insulin. Dextrose and sodium chlorides commonly used in the hospital for delivery medication. The present study also demonstrated that, PN did not fulfill the patients requirement and there were no patients monitoring. PN found to be used most frequently in some condition were where in real need such as pulmonary disease, GIT disorder and renal disease. Furthermore, TPN provided for the admitted patients include in emergencies, therapeutic and for unconscious patients. There were reported a number of complication in patient received PN due to lack of monitoring and prolong replacements of PN drainage. PPN (Iv drips) were the most common uses at the hospital and longer duration was proved which might led to patients burden in the hospital. Furthermore, due to the uses of PPN for longer times this could contribute for patients malnutrition. Our data suggested that, comprehensive nutrition support team and provision of intervention programs in order to increased quality and reduced patients burden and also the result of our study needed to be validated in large sample to know the real role of dietitian and pharmacist for ordered of drugs and nutrients and nutrients drug interactions. Keywords: Nutrients, Provision, TPN, PN, complication, medications.

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Nutrition Support. Parenteral Nutrition (1)

Farmacist ro ◽

10.26416/farm.188.3.2019.2410 ◽

2019 ◽

Vol 3 (188) ◽

pp. 9

Author(s):

Cristina Daniela Marineci ◽

Emil Ștefănescu ◽

Cornel Chiriţă

Keyword(s):

Parenteral Nutrition ◽

Nutrition Support

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Impact of Propofol Sedation upon Caloric Overfeeding and Protein Inadequacy in Critically Ill Patients Receiving Nutrition Support

Pharmacy ◽

10.3390/pharmacy9030121 ◽

2021 ◽

Vol 9 (3) ◽

pp. 121

Author(s):

Roland N. Dickerson ◽

Christopher T. Buckley

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Enteral Nutrition ◽

Parenteral Nutrition ◽

Critically Ill Patients ◽

Protein Intake ◽

Lipid Emulsion ◽

Caloric Intake ◽

Nutrition Therapy ◽

Nutrition Support

Propofol, a commonly used sedative in the intensive care unit, is formulated in a 10% lipid emulsion that contributes 1.1 kcals per mL. As a result, propofol can significantly contribute to caloric intake and can potentially result in complications of overfeeding for patients who receive concurrent enteral or parenteral nutrition therapy. In order to avoid potential overfeeding, some clinicians have empirically decreased the infusion rate of the nutrition therapy, which also may have detrimental effects since protein intake may be inadequate. The purpose of this review is to examine the current literature regarding these issues and provide some practical suggestions on how to restrict caloric intake to avoid overfeeding and simultaneously enhance protein intake for patients who receive either parenteral or enteral nutrition for those patients receiving concurrent propofol therapy.

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Metabolic Complications of Total Parenteral Nutrition: Effects of a Nutrition Support Service

Journal of Parenteral and Enteral Nutrition ◽

10.1177/0148607196020003206 ◽

1996 ◽

Vol 20 (3) ◽

pp. 206-210 ◽

Cited By ~ 25

Author(s):

Donna Chrisanderson ◽

Douglas C. Heimburger ◽

Sarah L. Morgan ◽

Wilma J. Geels ◽

Kathy L. Henry ◽

...

Keyword(s):

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Support Service ◽

Nutrition Support ◽

Metabolic Complications

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Nutrition support teams: an integral part of developing a gastroenterology service.

Gut ◽

10.1136/gut.37.6.740 ◽

1995 ◽

Vol 37 (6) ◽

pp. 740-742 ◽

Cited By ~ 9

Author(s):

N Reynolds ◽

J P McWhirter ◽

C R Pennington

Keyword(s):

Nutrition Support ◽

Support Teams

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Diagnosis and management of catheter-related bloodstream infections in patients on home parenteral nutrition

Frontline Gastroenterology ◽

10.1136/flgastro-2018-101094 ◽

2019 ◽

Vol 11 (1) ◽

pp. 48-54 ◽

Cited By ~ 3

Author(s):

Ashley Bond ◽

Paul Chadwick ◽

Trevor R Smith ◽

Jeremy M D Nightingale ◽

Simon Lal

Keyword(s):

Parenteral Nutrition ◽

Bloodstream Infections ◽

Venous Catheter ◽

Nutrition Support ◽

Central Venous ◽

Short Term ◽

Qualitative And Quantitative ◽

Central Venous Catheter Removal ◽

Support Team

Catheter-related bloodstream infections (CRBSIs) commonly arise from a parenteral nutrition catheter hub. A target for a Nutrition Support Team is to have a CRBSI rate of less than 1 per 1000. The diagnosis of CRBSI is suspected clinically by a temperature shortly after setting up a feed, general malaise or raised blood inflammatory markers. It is confirmed by qualitative and quantitative blood cultures from the catheter and peripherally. Treatment of inpatients may involve central venous catheter removal and antibiotics for patients needing short-term parenteral nutrition, but catheter salvage is generally recommended for patients needing long-term parenteral nutrition, where appropriate.

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