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Reducing the Inappropriate Use of Parenteral Nutrition in an Acute Care Teaching Hospital
Author(s) -
Maurer James,
Weinbaum Fred,
Turner James,
Brady Terrence,
Pistone Barbara,
D'Addario Virginia,
Lun Wing,
Ghazali Baseth
Publication year - 1996
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607196020004272
Subject(s) - parenteral nutrition , medicine , multidisciplinary approach , prospective cohort study , advisory committee , enteral administration , intensive care medicine , emergency medicine , surgery , social science , public administration , sociology , political science
Background: Parenteral nutrition (PN) is a form of nutrition that can be life‐saving, but its use has inherent risks and it is expensive. Nutrition support teams have been shown to reduce both the rate of complications and excessive use of PN. Methods: Criteria were established to evaluate the appropriateness of PN use in a 487‐bed community teaching hospital. A prospective study of 50 consecutive patients, who received either central or peripheral PN, was conducted. Results: The 50 patients received 469 days of PN. We found that 233 (49.7%) of the 469 days of PN were avoidable. This resulted in the creation of a formal approval process that required prior approval by a physician‐directed multidisciplinary advisory committee before PN could be instituted. The amount of PN subsequently decreased from 500 patient days of PN per month to less than 100. Conclusions: This study supports the idea that inappropriate use of PN can be reduced by physician education plus the continuing oversight of a physician‐directed multidisciplinary advisory group. (Journal of Parenteral and Enteral Nutrition 20 :272–274, 1996)