Of lobsters, electronic medical records, and neonatal total parenteral nutrition

Area of Science:

• Neonatal Pharmacy Practice
• Clinical Informatics
• Medication Safety

Background:

• Over 1000 infant total parenteral nutrition (TPN) orders are processed annually at Mayo Health System, LaCrosse.
• TPN orders represent the most complex prescription managed by the pharmacy.
• A lack of commercially available, stand-alone TPN calculators and limited electronic medical record integration for neonatal TPN necessitated an in-house solution.

Discussion:

• Developing proprietary TPN software addresses the critical need for specialized tools in neonatal care.
• The custom software enhances order legibility and integrates decision support, reducing the cognitive burden on physicians.
• This initiative highlights the broader implications of healthcare providers creating their own TPN software solutions.

Key Insights:

• The developed TPN software significantly minimizes mathematical errors in neonatal medication orders.
• Implementation led to improved consistency and legibility of TPN orders.
• Physician reliance on manual calculations for TPN orders was reduced, enhancing workflow efficiency.

Outlook:

• Future advancements may focus on wider adoption of such custom TPN software in pediatric healthcare settings.
• Continued development could integrate more sophisticated decision support algorithms for complex neonatal nutritional needs.
• This case study may encourage other institutions to explore in-house software development for critical medication management.