TY - JOUR
T1 - Wastage of standardised parenteral nutrition solution – a challenge for neonatal units
AU - Deshmukh, Mangesh
AU - Grzejszczyk, Jessica
AU - Mehta, Shailender
AU - Patole, Sanjay
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background: Standardised parental nutrition (PN) has been used in many neonatal intensive care unit (NICU). Easy accessibility, better provision of nutrients, reduced prescription errors and cost savings are some of its benefits. Fixed large volume (e.g. 750–1000 mL) and short expiry limit (48 hrs) along with changing metabolic needs of neonates leads to significant wastage of PN solution. Objective: To evaluate wastage of PN solution in our 22-bedded NICU. Methods: The audit was conducted over 21-month period (July 2015–April 2017). Data on PN use (e.g. type, duration, infused volume, residual after use) was obtained from hospital records. The discarded volume of PN was estimated after subtracting the administered volume based on the rate of infusion from the total volume in the bag. Cumulative “discarded” volume as percentage of the total “supplied” volume was calculated. Results: A total of 305-PN bags (Standardised: Preterm: 222, Term: 83) were used. The estimated total used, discarded, and percentage discarded volumes for standard preterm and term PN were 78.1, 88 L, 53% and 33.5, 49.7 L, and 59.8%, respectively. Conclusions: There was more than 50% wastage of PN solution in our NICU. The estimated cost of this PN wastage was around 21,000 AUD over 21 months. Strategies such as minipack should be explored to prevent such losses.
AB - Background: Standardised parental nutrition (PN) has been used in many neonatal intensive care unit (NICU). Easy accessibility, better provision of nutrients, reduced prescription errors and cost savings are some of its benefits. Fixed large volume (e.g. 750–1000 mL) and short expiry limit (48 hrs) along with changing metabolic needs of neonates leads to significant wastage of PN solution. Objective: To evaluate wastage of PN solution in our 22-bedded NICU. Methods: The audit was conducted over 21-month period (July 2015–April 2017). Data on PN use (e.g. type, duration, infused volume, residual after use) was obtained from hospital records. The discarded volume of PN was estimated after subtracting the administered volume based on the rate of infusion from the total volume in the bag. Cumulative “discarded” volume as percentage of the total “supplied” volume was calculated. Results: A total of 305-PN bags (Standardised: Preterm: 222, Term: 83) were used. The estimated total used, discarded, and percentage discarded volumes for standard preterm and term PN were 78.1, 88 L, 53% and 33.5, 49.7 L, and 59.8%, respectively. Conclusions: There was more than 50% wastage of PN solution in our NICU. The estimated cost of this PN wastage was around 21,000 AUD over 21 months. Strategies such as minipack should be explored to prevent such losses.
KW - Audit
KW - cost
KW - neonate
KW - parenteral nutrition
KW - standardised
UR - http://www.scopus.com/inward/record.url?scp=85044720643&partnerID=8YFLogxK
U2 - 10.1080/14767058.2018.1455088
DO - 10.1080/14767058.2018.1455088
M3 - Article
C2 - 29606021
AN - SCOPUS:85044720643
SP - 1
EP - 4
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
SN - 1476-4954
ER -