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Practice ordering guidance for neonatal parenteral nutrition
1Department of Pediatrics, Wake Forest University, Winston-Salem, NC 27157, USA. porcelli@wfubmc.edu
Summary
Neonatal parenteral nutrition (PN) order forms offer minimal clinical practice guidance. Standardizing electronic neonatal nutrition order design is needed due to significant variations in current paper forms.
Area of Science:
- Neonatology
- Clinical Nutrition
- Health Informatics
Background:
- Neonatal parenteral nutrition (PN) is crucial for very low birth weight infants with inadequate enteral intake.
- Evaluating current paper-based PN order forms provides a baseline for improving electronic systems.
Purpose of the Study:
- To assess the clinical practice guidance (CPG) content of neonatal PN order forms.
- To establish a reference for designing future electronic neonatal nutrition order systems.
Main Methods:
- A scoring system was developed to evaluate CPG on printed PN order forms from nine institutions.
- Scores ranged from generic reminders to patient-specific recommendations with order entry.
- User-friendliness and completion time were also assessed.
Main Results:
- The overall CPG score was 1.85+/-0.68, indicating a 'generic reminder' level, lacking specific nutrient dose fields.
- Amino acids scored highest (2.05+/-0.64), while vitamins scored lowest.
- The institution of origin independently predicted the CPG score.
Conclusions:
- Paper neonatal PN order forms provide limited CPG.
- Significant variations in form design highlight the need for standardization in electronic neonatal PN ordering systems.
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