Developing and Implementing All-in-One Standard Paediatric Parenteral Nutrition

• Main Authors: Raoul I. Furlano, Marc A. Sidler, Caroline Kiss, Sven Schulzke, Rosan Meyer, Meike Timmermann
• Format: Article
• Language: English
• Published: MDPI AG 2013-06-01
• Series: Nutrients
• Subjects: parenteral nutrition; all-in-one parenteral nutrition; paediatrics; development; implementation
• Online Access: http://www.mdpi.com/2072-6643/5/6/2006

Parenteral nutrition (PN) is a feeding mode suitable for children that do not achieve requirements via the enteral route. For this intervention to be successful, healthcare professionals require: knowledge on nutrient requirements; access to an aseptic compounding facility; and a system that ensures adequate and safe delivery of PN. Previously, it was thought that individualised PN was the “gold standard” for delivering nutrients to children; however, studies have highlighted concerns regarding inadequate delivery of nutrients, prescribing and compounding errors. We, therefore, set out to develop and implement all-in-one (AIO) paediatric PN solutions. Through a systematic approach, four AIO PN solutions were developed: birth–two months of age (Ped 1); two months–10 kg (Ped 2); 11–15 kg (Ped 3); and 16–30 kg (Ped 4). We implemented them with the help of a teaching pack, over a one month time period, and reviewed usage at six months. At that time, five children initially received standard PN without electrolyte changes; but after a few days, electrolytes needed amendments, and three required individualised PN. A change to AIO PN is feasible and safe; however, some may require electrolyte changes, and there will always be those that will require individualised PN.