The Influence of Pediatric Nutrition Support Team on Hospitalized Pediatric Patients Receiving Parenteral Nutrition

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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PTU-116 The switch from bespoke parenteral nutrition to off-the-shelf bags may not be cost effective: experience from a dgh nutrition support team

10.1136/gutjnl-2017-314472.211 ◽

2017 ◽

Author(s):

D Lloyd ◽

C Best ◽

J Summers ◽

H Gordon

Keyword(s):

Parenteral Nutrition ◽

Cost Effective ◽

Nutrition Support ◽

Support Team

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Trends in the use parenteral nutrition over 10 years: re-audit of referrals to the nutrition support team (NST)

Proceedings of The Nutrition Society ◽

10.1017/s0029665108007337 ◽

2008 ◽

Vol 67 (OCE3) ◽

Author(s):

J. Davis ◽

V. Marvin

Keyword(s):

Parenteral Nutrition ◽

Nutrition Support ◽

Support Team

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Enteral and parenteral nutrition considerations in pediatric patients

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxz174 ◽

2019 ◽

Vol 76 (19) ◽

pp. 1492-1510

Author(s):

Mary Petrea Cober ◽

Kathleen M Gura

Keyword(s):

Best Practices ◽

Parenteral Nutrition ◽

Pediatric Patients ◽

Medication Administration ◽

Nutrition Support ◽

Disease States ◽

Pediatric Populations ◽

Enteral And Parenteral Nutrition ◽

Indications For Use ◽

Selection Of

Abstract Purpose Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. Summary The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. Conclusion The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.

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Evaluation of Parenteral Nutrition Management in a Hospital without a Formal Nutrition Support Team

Hospital Pharmacy ◽

10.1310/hpj4210-921 ◽

2007 ◽

Vol 42 (10) ◽

pp. 921-930 ◽

Cited By ~ 2

Author(s):

Nancy Toedter Williams

Keyword(s):

Parenteral Nutrition ◽

Laboratory Data ◽

Nutrition Support ◽

Preliminary Review ◽

Drug Usage ◽

Nutrition Management ◽

Usage Evaluation ◽

Integral Role ◽

Support Team ◽

One Year

Purpose A preliminary review of several adult inpatients receiving parenteral nutrition (PN) revealed opportunities for improvement. In response, a drug usage evaluation (DUE) was conducted to: 1) determine specific areas of adult PN management needing improvement; 2) evaluate the current PN order forms; 3) identify reasons for PN wastage; 4) establish pharmacist involvement in prescribing/monitoring of PN in a community hospital without a formal nutrition support team. Methods A prospective DUE was performed on various adults receiving PN from January through February 2005. The following data were collected and evaluated: 1) PN indication; 2) whether ordered PN formula met patients' estimated needs; 3) adequate adjustments of electrolyte or glucose imbalances; 4) appropriate ramping/tapering of PN; 5) appropriate laboratory data ordered. Additionally, a record was kept of PN solutions wasted from January through April 2005. Results Twenty-two adult patients receiving PN were prospectively reviewed. Protein and caloric needs were met in only 59% of patients (n = 13), and electrolytes were abnormal in 73% of patients (n = 16), with most physicians making minimal or no electrolyte adjustments. PN was not routinely ramped up upon initiation. Phosphorus, triglycerides, and prealbumin were not routinely monitored. An average of 14.5 PN bags was wasted per month. In response to these findings, the PN order forms were redesigned to facilitate appropriate monitoring and to facilitate physician-initiated consults for pharmacists to manage PN. One year after implementation, a 40% reduction in PN wastage was noted. Conclusions Pharmacists play an integral role in PN management, resulting in improved patient monitoring and a reduction in expensive PN wastage.

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