Parenteral Nutrition Practices in a Private Metropolitan Melbourne Hospital

Mr Daniel Platt1

1Cabrini Health, Malvern, Australia

Background
A dedicated multidisciplinary nutrition support team involved in parenteral nutrition screening, administration and monitoring is beneficial in terms of nutritional adequacy, complications, metabolic abnormalities and cost savings. Currently, there is no nutrition support team for the management of parenteral nutrition inpatients at a private hospital.

Aim
To assess the current parenteral nutrition practices for inpatients at a private hospital in order to determine the feasibility of a nutrition support team.

Methods
A retrospective cross-sectional audit was completed for patients receiving parenteral nutrition in 2017, with patient medical records and an electronic patient administration system used for data collection. Fifty patients were randomly selected for analysis. Parenteral nutrition-related complications, cessation, compliance with dietitian recommendations and nutritional adequacy were investigated.

Results
Parenteral nutrition was not indicated for 22% of patients; dietitian recommendations were adhered to in 53% of cases whilst only 76% achieved prescribed target rate. Complications (e.g., deranged liver function tests, hyperglycaemia) occurred in 94% of patients with 56% of these experiencing multiple complications. When parenteral nutrition was ceased, 74% of patients were on a diet but only 49% were meeting ≥50% of nutritional requirements orally.

Conclusions
This audit identified some shortfalls in parenteral nutrition-related practices at a private hospital. Inappropriate use of parenteral nutrition and rates of complications are significantly higher compared to previous research. Increased adherence to dietitian recommendations, a review of the parenteral nutrition formula, and development of a parenteral nutrition support team may promote improved practices in accordance with evidence-based guidelines and improve patient outcomes.


Biography:

Daniel is a clinical dietitian with over 7 years’ experience. He has been working at Cabrini Health for the last 4 years and is currently working in numerous inpatient areas including oncology, wound management, orthopaedics, nutrition support, gastrointestinal surgery and critical care. Daniel is passionate about improving the care provided to oncology patients especially those undergoing surgery.

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