A Retrospective Descriptive Study of Stat TPN Orders in the Neonatal Intensive Care Unit

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dc.contributor.author Dang, Lan
dc.contributor.author Durham, Chris
dc.contributor.author Ahlers-Schmidt, Carolyn R
dc.contributor.author Rankin, Alissa
dc.contributor.author Shaw, Jared
dc.contributor.author Bloom, Barry T
dc.date.accessioned 2012-08-27T19:58:39Z
dc.date.available 2012-08-27T19:58:39Z
dc.date.issued 2012-08-27
dc.identifier.uri http://hdl.handle.net/2271/1111
dc.description.abstract BACKGROUND: Total parenteral nutrition (TPN) is used in the Neonatal Intensive Care Unit (NICU) to meet metabolic demand and provide growth. To prevent harm from critical laboratory abnormalities, stat TPNs can be ordered urgently to change the content of infusing TPN. Each stat order breaks the daily cycle and often leads to additional stat orders. Limited supplies of ingredients brought focus on our liberal stat TPN policy and how to reduce the number of stat TPNs safely. The purpose of this project was to evaluate biochemical abnormalities associated with stat TPNs and identify leverage points to reduce stat TPNs in NICU patients. METHODS: Data from 1/1/10 to 6/30/10 were abstracted from Meditech, NeoData, and patient charts for NICU stat TPN orders. Demographics, laboratory results (sodium, potassium, calcium, and glucose), and key variables were gathered and critical laboratory values were identified. RESULTS: A total of 112 patients had evaluable orders for 255 stat TPNs. Mean gestation was 31 weeks (SD = 5) and birth weight was 1.744 kg (SD = 0.993). Seven (3%) were never infused. Twenty (12.6%) of first stat TPNs were from patients taking nothing by mouth. Eighty-eight of first stat TPNs had no critical labs (55% of initial stat TPNs). Of follow-up stat orders, 43% (38/89) followed unnecessary initial stat TPNs. Of the 55 abnormalities that generated the initial stat TPNs, 44 (80%) corrected. CONCLUSIONS: Fifty-two percent of stat TPNs could not be justified. For situations that were justified, 20% of laboratory abnormalities from initial stat TPNs were not corrected. These data provide an opportunity to reduce unnecessary costs and save limited resources. en_US
dc.subject.mesh neonates
dc.subject.mesh total parenteral nutrition
dc.subject.mesh neonatal intensive care
dc.subject.mesh electrolyte balance
dc.title A Retrospective Descriptive Study of Stat TPN Orders in the Neonatal Intensive Care Unit en_US
dc.type Article en_US
rft.spage 79 en_US
dc.contributor.organization Institution:The University of Kansas Medical Center:KU School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214-3199, USA. en_US
dc.ispartof.issn 1948-2035
dc.ispartof.issue 3 en_US
dc.ispartof.title Publication::Kansas Journal of Medicine en_US
dc.ispartof.volume 5 en_US

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