Evaluation of Parenteral Nutrition Errors in an Era of Drug Shortages

Storey, Michael A.; Weber, Robert J.; Besco, Kelly; Beatty, Stuart J.; Aizawa, Kumiko; Mirtallo, Jay M.

doi:10.1177/0884533615608820

Cited by 24 publications

(36 citation statements)

References 17 publications

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“…Patients dependent on PN require ILE to help meet energy requirements and to deliver essential and conditionally essential fatty acids. Of note, 20% of PN‐related medication errors involve ILE 23 . The ILE is administered separately from the rest of the PN components based on local practice, when using a 2‐chambered standardized commercially available PN product, or when a prescribed formulation is not expected to be as stable as a TNA emulsion.…”

Section: Discussionmentioning

confidence: 99%

Lipid Injectable Emulsion Survey With Gap Analysis

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Lipid Injectable Emulsion Survey With Gap Analysis

et al. 2017

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“…Although this may be true generally for PN, the focus here is on the handling of the ILE specifically. In fact, ≈20%–30% of clinically relevant PN‐related medication errors involve ILE . Preparation tasks include compounding admixtures or activating commercial MCBs with additives, then labeling and dispensing them appropriately .…”

Section: Ile In the Pn‐use Processmentioning

confidence: 99%

Use of Intravenous Lipid Emulsions With Parenteral Nutrition: Practical Handling Aspects

Boullata

Berlana

Piętka³

et al. 2020

J Parenter Enteral Nutr

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A number of topics important to the handling of intravenous lipid emulsions (ILEs) were discussed at the international summit. ILE handling includes the preparation and the administration steps in the typical use of parenteral nutrition (PN). The discussion and consensus statements addressed several issues, including standardization of the PN process, use of commercially available multi‐chamber PN or compounded PN bags, the supervision by a pharmacist with expertise, limiting ILE repackaging, and infusion duration.

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“…PN product shortages are another potential source contributing to adverse events . Patients receiving HPN are particularly vulnerable to harm related to product shortages because they are not as closely monitored as those receiving PN in the hospital.…”

Section: Home Infusion Challengesmentioning

confidence: 99%

Challenges and Obstacles of Long‐Term Home Parenteral Nutrition

Kumpf

2019

Nut in Clin Prac

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Patients receiving long‐term home parenteral nutrition (HPN) and clinicians managing their care face complex challenges not fully addressed by existing clinical practice guidelines. This review aims to increase awareness of some of the challenges encountered when managing patients receiving HPN and provide strategies for management. The ability to optimally manage these patients starts with involvement of a qualified team of clinicians, which is sometimes difficult to find. There are unique challenges related to the parenteral nutrition (PN) prescribing and compounding process that are not typically encountered with inpatient use. Clear communication is required between the HPN prescriber/team and the home infusion pharmacist to prevent errors related to misinterpretation of the order and PN product shortages. Dependency on HPN and living with chronic disease create a number of psychosocial, financial, and other lifestyle restrictions that can negatively impact a patient's quality of life. HPN nonadherence is a challenge that complicates the clinician's ability to accurately assess and make appropriate adjustments to therapy. HPN adherence may be improved by incorporating a patient‐centered approach to care that allows patients to prioritize those issues most meaningful and valuable to them. Patient‐centered care also encourages self‐care and relies on a high level of HPN education. Clinicians are encouraged to use an interactive interview style when engaging patients to prioritize goals of care and make self‐motivated decisions for change. In spite of challenges, HPN therapy has allowed patients the ability to maintain adequate nutrition and thrive in the home setting when the oral/enteral route fails.

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Evaluation of Parenteral Nutrition Errors in an Era of Drug Shortages

Abstract: Despite the significant impact that shortages have had on the PN use system, no adverse impact on patient safety could be identified from these reported PN errors.

Cited by 24 publications

References 17 publications

Lipid Injectable Emulsion Survey With Gap Analysis

Lipid Injectable Emulsion Survey With Gap Analysis

Use of Intravenous Lipid Emulsions With Parenteral Nutrition: Practical Handling Aspects

Challenges and Obstacles of Long‐Term Home Parenteral Nutrition

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