Assessing Appropriateness of Parenteral Nutrition Usage in an Acute Hospital

Background: Although parenteral nutrition (PN) has become an integral component of patient care, the risks and costs associated with this therapy must be weighed against the benefits. The Department of Nutrition and Dietetics at our tertiary referral, university-affiliated hospital has audited the u...

Full description

Saved in:
Bibliographic Details
Published in:Nutrition in clinical practice 2013-04, Vol.28 (2), p.232-236
Main Authors: Smyth, Niamh D., Neary, Elaine, Power, Siobhan, Feehan, Sinead, Duggan, Sinead N.
Format: Article
Language:English
Subjects:
clinical audit
Cost-Benefit Analysis
Dietetics - methods
Dietetics - standards
Guideline Adherence
Hospitals
Humans
Medical Audit
Nursing
parenteral nutrition
Parenteral Nutrition - utilization
parenteral nutrition, total
Patient Care - standards
Practice Guidelines as Topic
Referral and Consultation
Societies, Medical
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Although parenteral nutrition (PN) has become an integral component of patient care, the risks and costs associated with this therapy must be weighed against the benefits. The Department of Nutrition and Dietetics at our tertiary referral, university-affiliated hospital has audited the use of enteral nutrition and PN based on criteria devised from guidelines developed by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). We aimed to examine the use of PN over time and in particular to investigate the appropriate and inappropriate use of this feeding method. Materials and Methods: Each patient referred for PN was assessed by a dietitian and need for PN evaluated. The appropriateness of the PN was categorized according to predefined criteria. Results: A total of 1191 patients had 1409 episodes of PN during the study period. According to the predefined criteria, 82% of PN episodes were considered “appropriate.” PN was “appropriate but avoidable” in 13% of cases. In 5% of episodes, the commencement of PN was considered “inappropriate.” The use of appropriate PN increased significantly over the study period (P = .018). Conclusion: Most PN episodes were deemed appropriate. We saw 5% inappropriate usage, which is lower than reported in comparable studies. This study underlines the importance of continuous audit and evaluation of practice to maintain appropriate and evidence-based practice in nutrition support.
ISSN:0884-5336
1941-2452
DOI:10.1177/0884533612469988