A standardized parenteral nutrition solution: prescribing, use, processing, and material cost implications

The influence of a standardized parenteral nutrition solution (TPN) on prescribing patterns, use, preparation time, and material costs was studied. The percentage of patients receiving the standardized TPN was derived from a 5-month utilization study. A retrospective chart review evaluated 50 patients receiving nonstandardized TPN (Group I) and 48 patients receiving standardized TPN (Group II). A stopwatch motion study of the IV admixture service evaluated processing and compounding time. Material cost savings resulting from standardized TPN use was evaluated. Order changes in Group I patients occurred on the average of once every 3.4 days. Alterations in electrolyte composition accounted for 73% of order changes. Prescribing error frequency was 9.3% in Group I patients. After implementation of the standardized TPN solution, 73% of patients receiving TPN during the study period were prescribed the standardized solution. Prescribing error frequency was 0% in Group II patients. The standardized TPN solution decreased processing and compounding time by 55% (p less than 0.01) and decreased material cost by 19%. Although some patients require individualized solution formulae, a majority of adult patients tolerate standardized TPN without adverse metabolic complications. A standardized TPN solution can decrease processing and compounding time, favorably affect prescribing patterns, and lower solution costs without adversely affecting patient safety.