Assessing physician variability in parenteral nutrition orders given a set of patient parameters as a means of...

Diversity of physician training and experience results in variability of physicians' assessments of total parenteral nutrition needs for patients. The Surgery, Medicine, and Medicine Intensive Care team members at the Walter Reed Army Medical Center, Washington, DC, were asked individually to prescribe a parenteral nutrition order for a hypothetical patient with a given set of characteristics and laboratory parameters. The parenteral nutrition order form used provided the options of individualized or standardized total nutrient admixture/peripheral parenteral nutrition formulas. The variability of these orders was assessed and used as a basis for medical team education and individual prescriber counselling.