Related Experiment Video
Updated: Jul 13, 2026
04:53
A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
Error reduction when prescribing neonatal parenteral nutrition
Cynthia L Brown1, Nancy A Garrison, Alastair A Hutchison
1Department of Pharmacy, University at Buffalo, State University of New York, The Women and Children's Hospital of Buffalo, Kaleida Health, Buffalo, New York 14222-2006, USA.
American Journal of Perinatology
|July 13, 2007
Summary
Implementing an interactive computerized parenteral nutrition (PN) worksheet significantly reduced PN prescribing errors in a neonatal intensive care unit. This tool improved accuracy for all PN orders and especially for peripheral PN, benefiting patient safety.
Area of Science:
- Neonatal intensive care
- Pediatric pharmacology
- Patient safety
Background:
- Parenteral nutrition (PN) prescribing errors are a significant concern in neonatal intensive care units (NICUs).
- Previous audits identified high PN prescribing error rates, with pediatric residents making more errors than neonatal nurse practitioners (NNPs).
Purpose of the Study:
- To reduce the PN prescribing error rate by implementing an improved ordering process.
- To evaluate the impact of an interactive computerized PN worksheet on prescribing accuracy.
Main Methods:
- A retrospective cross-sectional study analyzed 480 parenteral nutrition (PN) orders.
- An interactive computerized PN worksheet was voluntarily implemented.
- A time management study was conducted to identify system improvements.
Main Results:
- The overall PN prescribing error rate decreased from 27.9% to 11.7%.
- Use of the interactive computerized PN worksheet reduced the error rate from 14.5% to 6.8% for all PN orders and from 29.3% to 9.6% for peripheral PN orders.
- No significant difference in error rates was observed between pediatric residents and NNPs after implementation.
Conclusions:
- An interactive computerized PN worksheet is effective in reducing parenteral nutrition (PN) prescribing errors.
- The tool is particularly beneficial for peripheral PN orders.
- System improvements in PN ordering, informed by time management studies, further enhance accuracy.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...